Individual provider Active NPI

Karen Deberry, LSW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1245739622
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.0010120 Issued in OH
Practice address
700 Bryden Rd., Ste 122
Columbus, OH 43215
Phone
(614) 681-0012
Fax
(614) 412-6944
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.0010120 OH Primary

Addresses

Primary practice location

700 Bryden Rd., Ste 122
Columbus, OH 43215

Mailing address

700 Bryden Rd., Ste 122
Columbus, OH 43215
Phone (614) 681-0012

Other identifiers 1

IdentifierTypeStateIssuer
0275136MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.0010120OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightlife Behavioral Health LLC CurrentSince Feb 9, 2025 Accepting new patients

Locations

700 Bryden Rd
Ste 122
Columbus, OH 43215
Phone (614) 681-0012

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1245739622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BRYDEN RD., STE 122",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "614-681-0012",
            "fax_number": "614-412-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BRYDEN RD., STE 122",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "614-681-0012",
            "fax_number": "614-412-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERRY",
        "first_name": "KAREN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0010120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0275136",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.