Individual provider Active NPI

Priscilla Hope Berube, LMHC

  • Mental Health Counselor
  • Smithfield, RI
National Provider Identifier
1376167510
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC01466 Issued in RI
Practice address
28 Cedar Swamp Rd
Smithfield, RI 02917-2447
Phone
(401) 321-4082
NPI assigned
Jun 3, 2020
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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 MHC01466 RI Primary

Addresses

Primary practice location

28 Cedar Swamp Rd
Smithfield, RI 02917-2447

Mailing address

28 Cedar Swamp Rd Unit 206
Smithfield, RI 02917-2447
Phone (401) 321-4082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20241202003101 RI Practitioner - Mental Health Counselor 2466987367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carol a. G. Gillen, LMHC, LLCGroup PAC ID 1850735580, 2 clinicians

Practice addresses (Care Compare)

28 Cedar Swamp Rd
Unit 206
Smithfield, RI 02917-2447
Phone (401) 222-9882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MHC01466RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carol a. G. Gillen, LMHC, LLC Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

28 Cedar Swamp Rd
Unit 206
Smithfield, RI 02917
Phone (401) 222-9882

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1376167510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CEDAR SWAMP RD UNIT 206",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029172447",
            "telephone_number": "401-321-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CEDAR SWAMP RD",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029172447",
            "telephone_number": "401-321-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERUBE",
        "first_name": "PRISCILLA",
        "middle_name": "HOPE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, RI

Sources for this page

Verify at the official NPI Registry.