Active NPI
Jill Berson, LMHC
- Mental Health Counselor
- Marlborough, MA
National Provider Identifier
1063143196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4629
- Practice address
- 204 W Main St Unit B
Marlborough, MA 01752-3890 - Phone
- (508) 277-7381
- NPI assigned
- Jun 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4629 | MA | Primary |
Addresses
Primary practice location
204 W Main St Unit B
Marlborough, MA 01752-3890
Mailing address
204 W Main St Unit B
Marlborough, MA 01752-3890
Phone (508) 277-7381
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4629 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1063143196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 W MAIN ST UNIT B",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017523890",
"telephone_number": "508-277-7381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 W MAIN ST UNIT B",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017523890",
"telephone_number": "508-277-7381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERSON",
"first_name": "JILL",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-20",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.