Individual provider Active NPI

Jason Berl

  • Professional Counselor
  • Warner Robins, GA
National Provider Identifier
1508215658
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APC004721 Issued in GA
Practice address
104 Borders Way Ste 200
Warner Robins, GA 31088-8975
Phone
(478) 387-8937
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 APC004721 GA Primary

Addresses

Primary practice location

104 Borders Way Ste 200
Warner Robins, GA 31088-8975

Mailing address

104 Borders Way Ste 200
Warner Robins, GA 31088-8975
Phone (478) 387-8937

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
APC004721GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1508215658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BORDERS WAY STE 200",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888975",
            "telephone_number": "478-387-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BORDERS WAY STE 200",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888975",
            "telephone_number": "478-387-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERL",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC004721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.