Individual provider Active NPI

Claudia Bergmann, MA

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1376115931
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3027 San Diego Rd
Jacksonville, FL 32207-3691
Phone
(904) 493-7744
NPI assigned
Jul 13, 2021
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X FL Primary

Addresses

Primary practice location

3027 San Diego Rd
Jacksonville, FL 32207-3691

Mailing address

45 Longview Way N
Palm Coast, FL 32137-4570
Phone (917) 403-7540

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Buckner.clinical@chsfl.org Other

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1376115931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LONGVIEW WAY N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374570",
            "telephone_number": "917-403-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 SAN DIEGO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073691",
            "telephone_number": "904-493-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMANN",
        "first_name": "CLAUDIA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Buckner.clinical@chsfl.org",
            "affiliation": "N",
            "endpointDescription": "Clinical Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Clinical Information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Clinical Information",
            "address_1": "3027 San Diego Rd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322073691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.