Stacy Ann Berg, LPC

Primary specialty

Health EducatorTaxonomy code 174H00000X

License

21410447 Issued in OK

Practice address

550 S Peoria Ave
Tulsa, OK 74120-3820

Phone

(918) 588-1900

Fax

(918) 582-6405

NPI assigned

Oct 25, 2006

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

Other names 1

• Stacy Ann Markum Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Indian Health Care Resource Center

  • Clinic/Center
  • Tulsa, OK
  • NPI 1427034958

  TX

  Medicare reassignment NPD
• Indian Health Care Resource Center of Tulsa, Inc.

  • Pharmacy
  • Tulsa, OK
  • NPI 1457447609
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1396829065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3570",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "OK",
            "license": "21410447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200566570 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MARKUM",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aisha Elan Bereal
• Danna Rebecca Berends
• Carol Berg
• Carolyn M Berg, M.D.
• Hannah Berg, PHD
• Molly T Berger, MACCC/SLP
• Sheldon Curtis Berger, D.O.
• Brittany Bergeron, B.S
• Colin Oliver Bergeron, PA-C
• Emily Montana Bergeron, PHYSICIAN ASSISTANT

• Health Educator in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Health Educator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.