Jody Dominique Berg, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701012339 Issued in VA

Practice address

10128 Hull Street Rd
Midlothian, VA 23112-3300

Phone

(804) 744-1114

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1194428649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10128 HULL STREET RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123300",
            "telephone_number": "804-744-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10128 HULL STREET RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123300",
            "telephone_number": "804-744-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JODY",
        "middle_name": "DOMINIQUE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701012339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Sanford Bennett
• Lance Bennett, PT, DPT, CSCS
• Katherine Benson
• Ruth Bentley
• Vivien A Berft
• Meredith M Berger, MD
• Cecilia Bergh, MD
• Lawrence D Berndt, P.A.-C.
• Jane Avery Bernstein, LCSW
• Christopher D Berry, DPT

• Mental Health Counselor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.