Individual provider Active NPI

Michael Berry, LCMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1346660388
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2845 Issued in KS
Practice address
11940 W Central Ave Ste 118
Wichita, KS 67212-5180
Phone
(316) 302-5462
NPI assigned
Apr 17, 2014
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2845 KS Primary

Addresses

Primary practice location

11940 W Central Ave Ste 118
Wichita, KS 67212-5180

Mailing address

11940 W Central Ave Ste 118
Wichita, KS 67212-5180
Phone (316) 302-5462

Other practice location 1

110 S Main St Ste 500
Wichita, KS 67202-3745
Phone (316) 351-7644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240430001525 KS Practitioner - Marriage and Family Therapist 0042650624 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2845KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Counseling LLC Marriage & Family Therapist CurrentSince Apr 1, 2024 Accepting new patients

Locations

11940 W Central Ave
Ste 118
Wichita, KS 67212
Phone (316) 302-5462

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1346660388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 W CENTRAL AVE STE 118",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125180",
            "telephone_number": "316-302-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 W CENTRAL AVE STE 118",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125180",
            "telephone_number": "316-302-5462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S Main St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672023745",
            "country_code": "US",
            "telephone_number": "316-351-7644",
            "fax_number": "316-351-7689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.