Individual provider Active NPI

Mitchell Berry, PLMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1033733761
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12192 Issued in NE
Practice address
13906 Gold Cir Ste 202
Omaha, NE 68144-2336
Phone
(402) 932-6500
NPI assigned
May 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12192 NE Primary

Addresses

Primary practice location

13906 Gold Cir Ste 202
Omaha, NE 68144-2336

Mailing address

13906 Gold Cir Ste 202
Omaha, NE 68144-2336
Phone (402) 932-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12192NEMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1033733761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13906 GOLD CIR STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442336",
            "telephone_number": "402-932-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13906 GOLD CIR STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442336",
            "telephone_number": "402-932-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MITCHELL",
        "credential": "PLMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.