Jacqueline Rae Carlisle-Berkley, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3208 Issued in TN

Practice address

130 Hillcrest Dr
Suite 204
Clarksville, TN 37043-5064

Phone

(931) 494-6803

NPI assigned

Aug 18, 2009

Last updated

Feb 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Sunrise Counseling Services LLC

  • Professional Counselor
  • Clarksville, TN
  • NPI 1780191114
  NPD Authorized official

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1487886933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HILLCREST DR",
            "address_2": "SUITE 204",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435064",
            "telephone_number": "931-494-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HILLCREST DR",
            "address_2": "SUITE 204",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435064",
            "telephone_number": "931-494-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE-BERKLEY",
        "first_name": "JACQUELINE",
        "middle_name": "RAE",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "3208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caresourcerx LLC
• Caring Family Practice
• Caring Family Practice PLLC
• Caring Hearts Supportive Services, LLC
• Carla L. Jones O.D
• Vincent Felix Carlisle
• Nicholas Michael Carlson, DMD
• Carlyle Counseling Services, PLLC
• Willette P. Carlyle, MA., LPC-MHSP
• Joshua Carman

• Mental Health Counselor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.