Rebecca Lynn Beronja

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401010825 Issued in MI

Practice address

1125 E Milham Ave Ste B
Portage, MI 49002-3096

Phone

(269) 312-1446

NPI assigned

Jan 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Moxie Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kalamazoo, MI
  • NPI 1467132837

  MI

  Medicare reassignment NPD Authorized official
• Serene Solutions

  • Professional Counselor
  • Portage, MI
  • NPI 1326545260

  Professional

  NPD (past)

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1386975951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E MILHAM AVE STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023096",
            "telephone_number": "269-312-1446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Michigan Ave W",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490173602",
            "country_code": "US",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4341 S Westnedge Ave Ste 1106",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490083283",
            "country_code": "US",
            "telephone_number": "269-312-1446",
            "fax_number": "269-775-1079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERONJA",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-21",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401010825",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6401010825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Casey Bennett
• Katelin Anne Bensman
• Janeen Bertolina
• Beta Homes LLC
• Karen L Betten, M.D.
• Angelic Betterley, BS
• Joel Lawrence Bez, DO

• All providers in Portage, MI
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.