Individual provider Active NPI

Kariann Kay Pajak Bergeron, MA

  • Marriage & Family Therapist
  • Brown Deer, WI
National Provider Identifier
1598071631
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1869 Issued in MN
Practice address
3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209-1220
Phone
(414) 540-2170
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1869 MN Primary

Addresses

Primary practice location

3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209-1220

Mailing address

3088 Northwood Rd
Suamico, WI 54313-8241
Phone (612) 508-6232

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1869MNMDSports Medicine (Neuromusculoskeletal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1598071631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3088 NORTHWOOD RD",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "543138241",
            "telephone_number": "612-508-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE 200",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220",
            "telephone_number": "414-540-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJAK BERGERON",
        "first_name": "KARIANN",
        "middle_name": "KAY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.