Luna Psych

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LUNA PSYCH

Doing business as

JENNIFER BERRY

Practice address

1630 Fort St
Lincoln Park, MI 48146-1902

Phone

(313) 217-1298

NPI assigned

Jan 9, 2025

Organization subpart

No

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

Authorized official

Name

Jennifer Berry, PMHNPNPI 1720807431

Title

Owner

Phone

(313) 217-1298

Specialties & licenses 1

Addresses

Other names 1

• JENNIFER BERRY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer S Berry, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dearborn, MI
  • NPI 1720807431
  NPD Authorized official

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1538979844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 KINGSBURY AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281581",
            "telephone_number": "313-217-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481461902",
            "telephone_number": "313-217-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA PSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-217-1298",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JENNIFER BERRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.