Individual provider Active NPI

Margaret Ruth Bergmann, PSYD, LPC

  • Professional Counselor
  • Scott Afb, IL
National Provider Identifier
1497904684
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.009816 Issued in IL
Practice address
2443 Oakgrove Cir
Scott Afb, IL 62225-1447
Phone
(661) 754-2095
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.009816 IL Primary

Addresses

Primary practice location

2443 Oakgrove Cir
Scott Afb, IL 62225-1447

Mailing address

2443 Oakgrove Cir
Scott Afb, IL 62225-1447
Phone (661) 754-2095

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

LicenseStateTypeSpecialty
178.009816ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1497904684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 OAKGROVE CIR",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622251447",
            "telephone_number": "661-754-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 OAKGROVE CIR",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622251447",
            "telephone_number": "661-754-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMANN",
        "first_name": "MARGARET",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PSYD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.009816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Afb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.