Gracie Berntsen, LPCC #14243

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

11590 W Bernardo CT Ste 110
San Diego, CA 92127-1624

Phone

(000) 000-0000

NPI assigned

Jun 9, 2021

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 5, 2025 through Jul 5, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Sarah Ray Clinical Psychologist Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1104522655

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1497322283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 MAIN ST # 159",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11590 W BERNARDO CT STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271624",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNTSEN",
        "first_name": "GRACIE",
        "credential": "LPCC #14243",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Alden Bernstein, MD
• Leonard Saul Bernstein, M.D.
• Melissa Dara Bernstein, PH.D
• Paul E. Bernstein, MD
• Robyn Ashley Bernstein
• Andrew D. Beros, M.D.
• Eric Berquist, D.O.
• Jessica Ruthanne Williams Berreckman, OTD, OTR/L
• Ramona Berrelleza, BA
• Andrea Berreondo

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.