Laura Ann Berg, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LW60796321 Issued in WA

Practice address

235 E Rowan Ave Ste 107
Spokane, WA 99207-1240

Phone

(509) 252-6446

Fax

(509) 252-6490

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifebond PLLCGroup PAC ID 4284162330, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Lifebond PLLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1003637521
  Medicare reassignment Care Compare group NPD Authorized official
• Laura Berg PLLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1922829449
  Medicare reassignment NPD Authorized official
• Revive Counseling Spokane, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
  • NPI 1316477805
  Medicare reassignment NPD
• Lifebond PLLC

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1205623485
  NPD Authorized official
• Revive Counseling Spokane, PLLC

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1306321567
  NPD (past)

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1124473087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-6842",
            "fax_number": "509-474-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E ROWAN AVE STE 107",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071240",
            "telephone_number": "509-252-6446",
            "fax_number": "509-252-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W Mission Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992012355",
            "country_code": "US",
            "telephone_number": "509-998-7115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 S Howard St Ste 321",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992013816",
            "country_code": "US",
            "telephone_number": "509-838-4128",
            "fax_number": "509-838-4816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5633 N Lidgerwood St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "99208",
            "country_code": "US",
            "telephone_number": "509-252-6446",
            "fax_number": "509-252-6490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60796321",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60796321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124473087",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Estee Lee Berg, RN
• Evan Berg, LMT
• Jeffery C Berg
• Jill Christie Berg, SLP
• Kayla Berg
• Lauren Alessandra Berg, RN
• Michael P Berg, MD
• Robert Jack Berg
• Matthew Joseph Bergam, MPT
• Anne-Marie C Bergeleen, ARNP

• Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.