Rebecca Berry, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25827 Issued in MN

Practice address

1032 Grand Ave Ste 202
Saint Paul, MN 55105-3064

Phone

(612) 315-9905

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Minnesota Ketamine and Wellness Institute PAGroup PAC ID 9739584855, 3 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Minnesota Ketamine and Wellness Institute PA

  • Anesthesiology Physician
  • Maple Grove, MN
  • NPI 1003408857
  Medicare reassignment Care Compare group NPD
• Through Therapy Collective, Inc

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1508324336
  Medicare reassignment NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709942400000",
    "number": "1427833342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 GRAND AVE STE 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053064",
            "telephone_number": "612-315-9905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3217 Hennepin Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084695",
            "country_code": "US",
            "telephone_number": "612-460-7098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "REBECCA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-03-09",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berres PT and Yoga LLC
• Danielle Y Berres, DPT
• Jessica L Berry, CD
• Michael Ray Berry, LGSW
• Nancy Jean Berry, OTR
• Jeffrey Scott Berryhill, PH.D
• Sally Berryman, MD
• Inez Bersie-Mize, LMFT
• Jill Bertelsen
• Jennifer Ann Bertolatus, LPCC

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; 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.