| Cobblestone Collective, LLC | |
|
2480 Executive Dr Ste 200 Saint Charles MO 63303-5608 | |
| (636) 422-0303 | |
| Not Available |
| Full Name | Cobblestone Collective, LLC |
|---|---|
| Speciality | Counselor |
| Location | 2480 Executive Dr Ste 200, Saint Charles, Missouri |
| Authorized Official Name and Position | Kristen Leigh Waterman (OWNER/LPC) |
| Authorized Official Contact | 6364220303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cobblestone Collective, LLC 107 Iron Gate Ct Saint Charles MO 63304-7278 Ph: (636) 699-5545 | Cobblestone Collective, LLC 2480 Executive Dr Ste 200 Saint Charles MO 63303-5608 Ph: (636) 422-0303 |
| NPI Number | 1104655075 |
|---|---|
| Provider Enumeration Date | 07/30/2024 |
| Last Update Date | 07/15/2025 |
| Certification Date | 07/15/2025 |
| Medicare PECOS PAC ID | 7012482060 |
|---|---|
| Medicare Enrollment ID | O20260408000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104655075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Kristen Waterman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780922476 PECOS PAC ID: 7315399425 Enrollment ID: I20260408000957 |
| Provider Name | Sarah Runk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376024901 PECOS PAC ID: 8325514615 Enrollment ID: I20260415000558 |
| Provider Name | Maria Rupprecht |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104533132 PECOS PAC ID: 3274009584 Enrollment ID: I20260415001084 |
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