Individual provider Active NPI

Kent Douglas Berry, MDIV, MA, LMFT

  • Marriage & Family Therapist
  • High Point, NC
National Provider Identifier
1396835666
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1147 Issued in NC
Practice address
836 W Lexington Ave
High Point, NC 27262-7481
Phone
(336) 505-5484
Fax
(336) 505-5483
NPI assigned
Oct 14, 2006
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1147 NC Primary

Addresses

Primary practice location

836 W Lexington Ave
High Point, NC 27262-7481

Mailing address

4332 Grassy Moss Dr
Greensboro, NC 27409-9702
Phone (336) 505-5484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240227002042 NC Practitioner - Marriage and Family Therapist 2668817917 Practice locations: High Point, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1147NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Family Therapy Services, PLLC Marriage & Family Therapist PastSince Aug 13, 2006 Accepting new patients

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1396835666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 GRASSY MOSS DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099702",
            "telephone_number": "336-505-5484",
            "fax_number": "336-505-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W LEXINGTON AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627481",
            "telephone_number": "336-505-5484",
            "fax_number": "336-505-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KENT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MDIV, MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.