Active NPI
Jennifer Yetter Berbach, LSW, MSW
- Social Worker
- Fayetteville, AR
National Provider Identifier
1477805471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW125823
- Practice address
- 1100 N. College Street
Veterans Health Care System of the Ozarks
Fayetteville, AR 72703 - Phone
- (479) 443-4301
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW125823 | PA | Primary |
Addresses
Primary practice location
1100 N. College Street
Veterans Health Care System of the Ozarks
Fayetteville, AR 72703
Mailing address
6004 Pleasant Dr
Rogers, AR 72758-9581
Phone (573) 842-5292
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW125823 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1477805471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6004 PLEASANT DR",
"city": "ROGERS",
"state": "AR",
"postal_code": "727589581",
"telephone_number": "573-842-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N. COLLEGE STREET",
"address_2": "VETERANS HEALTH CARE SYSTEM OF THE OZARKS",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-443-4301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERBACH",
"first_name": "JENNIFER",
"middle_name": "YETTER",
"credential": "LSW, MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-15",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW125823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.