NPIMap

Organization Active NPI

Dene S Berman Lifespan Counseling Associates

  • Mental Health Counselor
  • Beavercreek, OH
National Provider Identifier
1407991862
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DENE S BERMAN LIFESPAN COUNSELING ASSOCIATES
Practice address
1195 Meadow Bridge Dr Ste B
Beavercreek, OH 45434-4302
Phone
(937) 426-2079
Fax
(937) 426-0211
NPI assigned
Feb 21, 2007
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Shari Boone
Title
Office Manager
Phone
(937) 426-2079

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

1195 Meadow Bridge Dr Ste B
Beavercreek, OH 45434-4302

Mailing address

PO Box 340398
Beavercreek, OH 45434-0398
Phone (937) 426-2079

National Provider Directory

National Provider Directory

Locations

1195 Meadow Bridge Dr
Ste B
Beavercreek, OH 45434
Phone (937) 426-2079

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1407991862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340398",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454340398",
            "telephone_number": "937-426-2079",
            "fax_number": "937-426-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 MEADOW BRIDGE DR STE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454344302",
            "telephone_number": "937-426-2079",
            "fax_number": "937-426-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENE S BERMAN LIFESPAN COUNSELING ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-426-2079"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.