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MRS. PATRICIA A. ROOSEVELT LPC
NPI 1679096648
Counselor - Professional in Saint Louis, MO

Active since July 21, 2017PECOS Enrolled
1023 EXECUTIVE PARKWAY DR STE 10, SAINT LOUIS, MO 63141(314) 469-5522(314) 469-5504 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Jul 21, 2017 (2 updates tracked since 2017).

About Mrs. Patricia A. Roosevelt Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. PATRICIA A. ROOSEVELT LPC (NPI 1679096648) is an individual professional provider in Saint Louis, Missouri, licensed in Missouri (2014034443) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679096648
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. PATRICIA A. ROOSEVELTCredential: LPC
Location Address1023 EXECUTIVE PARKWAY DR STE 10Saint Louis, MO 63141-6323
Mailing Address210 Stanhope LnColumbia, IL 62236-3420 · (618) 977-0734 · Fax (618) 202-1078
Phone(314) 469-5522
Fax(314) 469-5504
Sole ProprietorNo
Enumeration DateJuly 21, 2017
Last NPPES UpdateJanuary 24, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2024
✔ NPI 1679096648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MO · 2014034443
1023 EXECUTIVE PARKWAY DR STE 10, Saint Louis, MO 63141
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Patricia A. Roosevelt Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Patricia Roosevelt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Patricia A. Roosevelt LLC
22 mi
Professional
101 MCCROSKY PROFESSIONAL PARK
Columbia, IL 62236
  • Reassigned Medicare billing, Illinois enrollment
NPI 1891288478 (618) 977-0734

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LILIAN M WERNER MAC, LPC
Counselor
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
SARA KAY COKER
Counselor (Mental Health)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
JOEL CHAPPEAU MAC, LPC
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
TRACIE WALLACE LPC
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
DORINDA PEYTON LPC
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
GINA MARIE BIRKEMEIER
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
CHAD RICHARD FRIZZELL LPC
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522
DR. JEREMY RUCKSTAETTER PHD, LPC, NCC
Counselor (Professional)
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141
St. Louis County (314) 469-5522

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 Patricia Roosevelt's NPI number?

The NPI number for Patricia Roosevelt is 1679096648. It was assigned to this individual provider in the NPPES registry on July 21, 2017.

Where is Patricia Roosevelt located?

Patricia Roosevelt practices at 1023 Executive Parkway Dr Ste 10, Saint Louis, MO 63141. The listed phone number is (314) 469-5522.

What is Patricia Roosevelt's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Patricia Roosevelt enrolled in Medicare?

Yes. Patricia Roosevelt is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Patricia Roosevelt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Patricia Roosevelt reassigns Medicare benefits to Patricia A. Roosevelt LLC (Columbia, IL). The 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 Patricia Roosevelt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Patricia Roosevelt accept?

Health plans from Anthem Blue Cross and Blue Shield, Medica and UnitedHealthcare list Patricia Roosevelt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Patricia Roosevelt was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.