Carly Jeanette Bersin

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7808 Pacific Ave Ste 9
Tacoma, WA 98408-7039

Phone

(360) 240-0022

NPI assigned

Nov 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• L.E.a.P.S and Beyond, Inc

  • Community/Behavioral Health Agency
  • Oak Harbor, WA
  • NPI 1538504592
  NPD (past)

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1376209023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18348 BRITCHEN ST SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985978964",
            "telephone_number": "253-337-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 PACIFIC AVE STE 9",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087039",
            "telephone_number": "360-240-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSIN",
        "first_name": "CARLY",
        "middle_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.members.centralreach.com",
            "affiliation": "N",
            "endpointDescription": "scheduling website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "scheduling sessions",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7808 Pacific Ave Ste 9",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984087039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Berry
• Donna Lee Berry, LMP
• Jonathan Paul Berry, M.D.
• Larel Jean Berry
• Matthew James Berry
• Tower P Bert
• Claudia Bertagnole
• Caleb M Bertelle
• Shawn Thomas Berthel, MS, LCMHC
• Elisa Bertram

• Behavior Technician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.