Individual provider Active NPI

Susan Berend

  • Counselor
  • Wichita Falls, TX
National Provider Identifier
1215400874
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
80893 Issued in TX
Practice address
1420 Twin Oaks St
Wichita Falls, TX 76302-2723
Phone
(940) 696-0181
NPI assigned
Jan 7, 2019
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 80893 TX Primary

Addresses

Primary practice location

1420 Twin Oaks St
Wichita Falls, TX 76302-2723

Mailing address

4933 Reginald Dr
Wichita Falls, TX 76308-5121
Phone (940) 733-0461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20251107000175 TX Practitioner - Mental Health Counselor 6608366646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1420 Twin Oaks St
Wichita Falls, TX 76302-2723

PO Box
Chattanooga, TN 37422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Counseling Ministry Inc CurrentSince Aug 19, 2025 Accepting new patients

Locations

1420 Twin Oaks St
Wichita Falls, TX 76302
Phone (940) 696-0181

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

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1215400874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 REGINALD DR",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763085121",
            "telephone_number": "940-733-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 TWIN OAKS ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022723",
            "telephone_number": "940-696-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREND",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "80893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.