Hazel Berry

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3692/ACTIVE Issued in OR

Practice address

412 Alder St
Brookings, OR 97415-9014

Phone

(541) 813-2535

Fax

(541) 813-2536

NPI assigned

Mar 11, 2015

Last updated

Mar 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adapt

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
  • NPI 1720010549

  Mental Health

  Medicare reassignment NPD
• Adapt

  dba Adapt Integrated Health Care

  • Federally Qualified Health Center (FQHC)
  • Bandon, OR
  • NPI 1194529289
  NPD
• Adapt

  dba Adapt Integrated Health Care

  • Community/Behavioral Health Agency
  • Brookings, OR
  • NPI 1760145338
  NPD
• Curry Community Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gold Beach, OR
  • NPI 1629322847
  NPD (past)

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1184017444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94235 MOORE ST STE 121",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974449704",
            "telephone_number": "541-813-2535",
            "fax_number": "541-813-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 ALDER ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159014",
            "telephone_number": "541-813-2535",
            "fax_number": "541-813-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "HAZEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3692/ACTIVE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Christine Barvoets, MED, CP
• Mallisa P Bates
• Holly Ann Battleson, LPC
• Suzanne Bedke, RPH
• Ashley N Benson
• Better Health Family Medical, LLC
• Raechele Darleen Bird
• Michael Edward Bisgrove, M.D.
• Michelle L Bishop, AU.D.
• Jeanne A. Bisson, M.A. LMFT

• Mental Health Counselor in Brookings, OR
• Providers in Brookings, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.