Active NPI
Tracy Leigh Berryhill, LCMHCA
- Mental Health Counselor
- Swansboro, NC
National Provider Identifier
1124690284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A17083
- Practice address
- 714 W Corbett Ave Ste 12
Swansboro, NC 28584-8437 - Phone
- (910) 939-8406
- Fax
- (252) 862-2999
- NPI assigned
- Jul 16, 2021
- Sex
- Female
- Sole proprietor
- No
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 | A17083 | NC | Primary |
Addresses
Primary practice location
714 W Corbett Ave Ste 12
Swansboro, NC 28584-8437
Mailing address
137 Dockside Dr
Jacksonville, NC 28546-9769
Phone (910) 429-5587
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 |
|---|---|---|---|
| A17083 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Wellness Counseling, PC | Mental Health | Current | Accepting new patients |
Locations
714 W Corbett Ave
Ste 12
Swansboro, NC 28584
Phone (910) 939-8406
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1124690284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 DOCKSIDE DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469769",
"telephone_number": "910-429-5587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 W CORBETT AVE STE 12",
"city": "SWANSBORO",
"state": "NC",
"postal_code": "285848437",
"telephone_number": "910-939-8406",
"fax_number": "252-862-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRYHILL",
"first_name": "TRACY",
"middle_name": "LEIGH",
"credential": "LCMHCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-16",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A17083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Swansboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.