Individual provider Active NPI

Gretchen Ann Berkowitch, PMHCNS-BC

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • Beverly, MA
National Provider Identifier
1295833028
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X
License
187314 Issued in MA
Practice address
100 Cummings Center
365D
Beverly, MA 01915
Phone
(978) 969-1623
Fax
(978) 969-6945
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 187314 MA Primary

Addresses

Primary practice location

100 Cummings Center
365D
Beverly, MA 01915

Mailing address

100 Cummings Center
Suite 365D
Beverly, MA 01915-6261
Phone (978) 969-1623

Other practice location 1

800 Cummings Ctr
Suite 266T
Beverly, MA 01915-6175
Phone (978) 921-1190 ext. 404

Other identifiers 1

IdentifierTypeStateIssuer
110079048AMedicaidMA

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)
Enrolled
Credentials
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gretchen a Berkowitch Pmhcns-BC Psychiatric/Mental Health, Child & Adolescent Current Accepting new patients
Northeast Behavioral Health Corporation PastSince May 8, 2017 Accepting new patients

Locations

100 Cummings Ctr
Ste 365D
Beverly, MA 01915
Phone (978) 335-0756

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295833028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CENTER",
            "address_2": "SUITE 365D",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156261",
            "telephone_number": "978-969-1623",
            "fax_number": "978-969-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CENTER",
            "address_2": "365D",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-969-1623",
            "fax_number": "978-969-6945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Cummings Ctr",
            "address_2": "Suite 266T",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019156175",
            "country_code": "US",
            "telephone_number": "978-921-1190 x404",
            "fax_number": "978-927-3724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERKOWITCH",
        "first_name": "GRETCHEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MA",
            "license": "187314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110079048A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.