Individual provider Active NPI

Michael Berry

  • Counselor
  • Tulsa, OK
National Provider Identifier
1487988291
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
5525 E 51St St
Suite 400
Tulsa, OK 74135-7461
Phone
(918) 388-6457
Fax
(918) 388-6456
NPI assigned
Sep 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

5525 E 51St St
Suite 400
Tulsa, OK 74135-7461

Mailing address

5525 E 51St St
Suite 400
Tulsa, OK 74135-7461
Phone (918) 388-6457

Other identifiers 1

IdentifierTypeStateIssuer
100746170GMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20240409000439 OK Practitioner - Mental Health Counselor 1850739970 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MTF Counseling Resources, LLC CurrentSince Mar 30, 2024 Accepting new patients
Improving Lives Counseling Services, Inc. CurrentSince Jun 27, 2024 Accepting new patients
Melton Health and Medical Services PastSince Mar 30, 2024 Accepting new patients

Locations

324 E Chestnut St
Coweta, OK 74429
Phone (918) 279-6565

6216 S Lewis Ave
Ste 180
Tulsa, OK 74136
Phone (918) 289-6531

Organizations & group practices 3

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": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1487988291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 E 51ST ST",
            "address_2": "SUITE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357461",
            "telephone_number": "918-388-6457",
            "fax_number": "918-388-6456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 E 51ST ST",
            "address_2": "SUITE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357461",
            "telephone_number": "918-388-6457",
            "fax_number": "918-388-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746170G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.