Individual provider Active NPI

Paige Berg, LPCC

  • Professional Counselor
  • Woodbury, MN
National Provider Identifier
1235744640
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC00524 Issued in MN
Practice address
6053 Hudson Rd Ste 344
Woodbury, MN 55125-1011
Phone
(651) 349-6970
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC00524 MN Primary

Addresses

Primary practice location

6053 Hudson Rd Ste 344
Woodbury, MN 55125-1011

Mailing address

350 Saint Clair Ave
Saint Paul, MN 55102-3110
Phone (952) 250-2009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260522000335 MN Practitioner - Mental Health Counselor 8527538396 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)

1818 Wooddale Dr
Suite 110
Woodbury, MN 55125-2947

8581 135TH St W
Apple Valley, MN 55124-9512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC00524MNMDProfessional Counselor

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": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1235744640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SAINT CLAIR AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023110",
            "telephone_number": "952-250-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 HUDSON RD STE 344",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251011",
            "telephone_number": "651-349-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "PAIGE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.