Active NPI
Jacqueline Leigh Berg, M.S, M.A., LMFT
- Marriage & Family Therapist
- Laconia, NH
National Provider Identifier
1386935641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 137
- Practice address
- 585 Union Ave, #7a
Laconia, NH 03246 - Phone
- (603) 387-1523
- Fax
- (815) 642-0356
- NPI assigned
- Apr 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 137 | NH | Primary |
Addresses
Primary practice location
585 Union Ave, #7a
Laconia, NH 03246
Mailing address
585 Union Ave, #5
Laconia, NH 03246
Phone (603) 387-1523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2024 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 137 | NH | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1386935641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 UNION AVE, #5",
"city": "LACONIA",
"state": "NH",
"postal_code": "03246",
"telephone_number": "603-387-1523",
"fax_number": "815-642-0356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 UNION AVE, #7A",
"city": "LACONIA",
"state": "NH",
"postal_code": "03246",
"telephone_number": "603-387-1523",
"fax_number": "815-642-0356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "JACQUELINE",
"middle_name": "LEIGH",
"credential": "M.S, M.A., LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NH",
"license": "137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laconia, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.