Individual provider Active NPI

Justin O Berry

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1427840941
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
058293600 Issued in GA
Practice address
2625 Sandy Plains Rd Ste 205
Marietta, GA 30066-4291
Phone
(770) 870-0455
NPI assigned
May 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 058293600 GA Primary

Addresses

Primary practice location

2625 Sandy Plains Rd Ste 205
Marietta, GA 30066-4291

Mailing address

2625 Sandy Plains Rd Ste 205
Marietta, GA 30066-4291
Phone (770) 870-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
058293600GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Berrygood Transportation LLC CurrentSince Jan 4, 2026 Accepting new patients

Locations

2625 Sandy Plains Rd
Ste 205
Marietta, GA 30066
Phone (678) 698-6313

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1427840941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 SANDY PLAINS RD STE 205",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664291",
            "telephone_number": "770-870-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SANDY PLAINS RD STE 205",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664291",
            "telephone_number": "770-870-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JUSTIN",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "058293600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.