Active NPI
Sandra Berna Lcmhc Emdr Integrative Services LLC
- Mental Health Counselor
- North Hero, VT
National Provider Identifier
1124746698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- SANDRA BERNA LCMHC EMDR INTEGRATIVE SERVICES LLC
- Practice address
- 1388 Blockhouse PT Rd
North Hero, VT 05474-9666 - Phone
- (802) 527-7494
- NPI assigned
- Aug 19, 2022
- Organization subpart
- Yes
- Parent organization
- SANDRA BERNA LCMHC EMDR INTEGRATIVE SERVICES LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra E Berna, LCMHC
- Title
- Owner
- Phone
- (802) 527-7494
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1388 Blockhouse PT Rd
North Hero, VT 05474-9666
Mailing address
1388 Blockhouse PT Rd
North Hero, VT 05474-9666
Phone (802) 527-7494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009871 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241028001101 | VT | Part B Supplier - Clinic/Group Practice | 3072046218 |
Receives reassigned benefits from 1 practitioner Practice locations: North Hero, VT |
National Provider Directory
National Provider Directory- Part of
- Sandra Berna Lcmhc Emdr Integrative Services LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719187200000",
"number": "1124746698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1388 BLOCKHOUSE PT RD",
"city": "NORTH HERO",
"state": "VT",
"postal_code": "054749666",
"telephone_number": "802-527-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1388 BLOCKHOUSE PT RD",
"city": "NORTH HERO",
"state": "VT",
"postal_code": "054749666",
"telephone_number": "802-527-7494"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SANDRA BERNA LCMHC EMDR INTEGRATIVE SERVICES LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SANDRA BERNA LCMHC EMDR INTEGRATIVE SERVICES LLC",
"enumeration_date": "2022-08-19",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A",
"authorized_official_last_name": "BERNA",
"authorized_official_first_name": "SANDRA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "802-527-7494",
"authorized_official_credential": "LCMHC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009871",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Hero, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.