Active NPI
Georgia Lee Berry, MA, LMFTA, LMHCA
- Marriage & Family Therapist
- Lacey, WA
National Provider Identifier
1346946167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MG61228444
- Practice address
- 6627 Carolina St SE
Lacey, WA 98513-5227 - Phone
- (360) 790-3882
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MG61228444 | WA | Primary |
Addresses
Primary practice location
6627 Carolina St SE
Lacey, WA 98513-5227
Mailing address
6627 Carolina St SE
Lacey, WA 98513-5227
Phone (360) 790-3882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2025 through Jan 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MG61228444 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1346946167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6627 CAROLINA ST SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985135227",
"telephone_number": "360-790-3882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6627 CAROLINA ST SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985135227",
"telephone_number": "360-790-3882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "GEORGIA",
"middle_name": "LEE",
"credential": "MA, LMFTA, LMHCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "MG61228444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.