Mary Bergens Dodson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0510 Issued in MS

Practice address

2620 Executive PL
Biloxi, MS 39531-3717

Phone

(228) 385-7744

Fax

(228) 385-5165

NPI assigned

Oct 8, 2018

Last updated

Jan 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Miss Mary Elizabeth Bergens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 15, 2024 through Feb 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Authorized official Same address or phone
• Psycamore, LLC

  • Adult Mental Health Clinic/Center
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  • NPI 1003195967
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1114492956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16109 S APRIL DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034181",
            "telephone_number": "985-774-4076",
            "fax_number": "228-385-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EXECUTIVE PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313717",
            "telephone_number": "228-385-7744",
            "fax_number": "228-385-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16109 S April Dr",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395034181",
            "country_code": "US",
            "telephone_number": "985-774-4076",
            "fax_number": "228-385-5165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODSON",
        "first_name": "MARY",
        "middle_name": "BERGENS",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MS",
            "license": "T0510",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "T0510",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "T0510",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MS",
            "license": "T0510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BERGENS",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Dixon, PHARM.D.
• Persharon M Dixon, M.D
• Sara Dixon, DDS
• Andy Nguyen Doan, MD
• Martin A Docherty, MD
• James Anderson Dollahite, M.D.
• Margo Anne Donaldson, NP
• Donna E Alexander MD Obstetrics and Gynecology LLC
• Michael D Dorcik, DO
• Murl D Dotson, PA-C

• Marriage & Family Therapist in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Marriage & Family Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.