Individual provider Active NPI

Gillian Irma Berry, LICSW, LCSW-C

  • Clinical Social Worker
  • Upper Marlboro, MD
National Provider Identifier
1356630842
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50078928 Issued in DC
Practice address
7905 Station Dr
Upper Marlboro, MD 20772-9273
Phone
(202) 330-1272
NPI assigned
Apr 5, 2011
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12841 MD
Clinical Social Worker 1041C0700X LC50078928 DC Primary

Addresses

Primary practice location

7905 Station Dr
Upper Marlboro, MD 20772-9273

Mailing address

7905 Station Dr
Upper Marlboro, MD 20772-9273
Phone (202) 330-1272

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
LC50078928DCMDClinical Social Worker
12841MDMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1356630842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 STATION DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729273",
            "telephone_number": "202-330-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 STATION DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729273",
            "telephone_number": "202-330-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "GILLIAN",
        "middle_name": "IRMA",
        "name_prefix": "Dr.",
        "credential": "LICSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12841",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.