Individual provider Active NPI

Brittany Joy Berge, MA, LMFT

  • Marriage & Family Therapist
  • Buffalo, MN
National Provider Identifier
1356089445
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
308 12TH Ave S.
Buffalo, MN 55313
Phone
(651) 829-1861
NPI assigned
May 26, 2022
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 Primary

Addresses

Primary practice location

308 12TH Ave S.
Buffalo, MN 55313

Mailing address

PO Box 308
Waverly, MN 55390
Phone (651) 829-1861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240119001484 MN Practitioner - Marriage and Family Therapist 0446602973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4166MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Counseling and Psychological Services CurrentSince Jan 1, 2024 Accepting new patients

Locations

14000 Northdale Blvd
Ste I
Rogers, MN 55374
Phone (763) 575-8086

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1356089445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "WAVERLY",
            "state": "MN",
            "postal_code": "55390",
            "telephone_number": "651-829-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 12TH AVE S.",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "55313",
            "telephone_number": "651-829-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGE",
        "first_name": "BRITTANY",
        "middle_name": "JOY",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.