Kristine Ann Grimes Bertelsen, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

000256 Issued in NY

Practice address

415 N Tioga St
Second Floor
Ithaca, NY 14850-4228

Phone

(607) 272-7247

NPI assigned

Mar 2, 2007

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

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497883193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 TRUMANSBURG RD.",
            "address_2": "P.O. BOX 157",
            "city": "JACKSONVILLE",
            "state": "NY",
            "postal_code": "148540157",
            "telephone_number": "607-387-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N TIOGA ST",
            "address_2": "SECOND FLOOR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504228",
            "telephone_number": "607-272-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTELSEN",
        "first_name": "KRISTINE",
        "middle_name": "ANN GRIMES",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myra J Berkowitz, MNS, RD, CDN
• Carol Thuytien Berlin, MD
• Michael Leon Berlin, M.D.
• Deanna Hope Berman, ND,CM
• Micahela Davey Berman
• Lisa Bertuzzi, RN
• Kathleen Besemer
• Naomi Sommers Bewley, LMSW
• Prerica Bhattarai
• Samjhauta Bhattarai, M.B.B.S

• Mental Health Counselor in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.