COBBLESTONE COLLECTIVE, LLC
NPI 1104655075
Counselor - Mental Health in Saint Charles, MO
About Cobblestone Collective, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COBBLESTONE COLLECTIVE, LLC (NPI 1104655075) is a healthcare organization registered as a mental health in Saint Charles, Missouri and active in the NPI registry since July 2024. The organization lists Kristen Leigh Waterman, Owner/lpc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cobblestone Collective, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Cobblestone Collective, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Cobblestone Collective, LLC's NPI number?
The NPI number for Cobblestone Collective, LLC is 1104655075. It was assigned to this organization in the NPPES registry on July 30, 2024.
Where is Cobblestone Collective, LLC located?
Cobblestone Collective, LLC is located at 2480 Executive Dr Ste 200, Saint Charles, MO 63303. The listed phone number is (636) 422-0303.
What is Cobblestone Collective, LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Cobblestone Collective, LLC enrolled in Medicare?
Yes. Cobblestone Collective, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Cobblestone Collective, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Mental Health Counselor, reassign their Medicare billing to Cobblestone Collective, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Cobblestone Collective, LLC was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Cobblestone Collective, Llc · NPI 1104655075
Mental Health organization in Saint Charles, Missouri. Organization record, active in the CMS NPPES registry since July 30, 2024.
## Identity
- **NPI:** 1104655075 (Entity type: Organization)
- **Enumerated:** July 30, 2024
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Kristen Waterman, OWNER/LPC
## Practice location
- **Address:** 2480 EXECUTIVE DR STE 200, Saint Charles, MO 63303-5608
- **Phone:** (636) 422-0303
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Mental Health Counselor) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104655075) · Data from the CMS NPPES public registry.