Katie C Bergman, LMHC, MC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH17204 Issued in FL

Practice address

2581 Huntcliff LN
Panama City, FL 32405-4902

Phone

(850) 520-3321

Fax

(850) 848-6490

NPI assigned

Oct 27, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• The Therapy Room Mind Health and Wellness LLC

  • Mental Health Counselor
  • Panama City, FL
  • NPI 1073120432
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1245635788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2581 HUNTCLIFF LN",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054902",
            "telephone_number": "850-520-3321",
            "fax_number": "850-848-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 HUNTCLIFF LN",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054902",
            "telephone_number": "850-520-3321",
            "fax_number": "850-848-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "KATIE",
        "middle_name": "C",
        "credential": "LMHC, MC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "PPC-863",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110724100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Bennett
• Tina Louise Bennett, MSW
• Melissa Benson
• Denesha Benton
• Amy Berger, LMT
• Lorraine Souder Bernhardt, O.T.
• Bernier Family Practice
• Aracelia Bernier, M.D.
• Rosa I Bernier, M.D.
• Patricia A. Bernstein, M.S., R.D., LD/N

• Mental Health Counselor in Panama City, FL
• Providers in Panama City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.