Active NPI
Christopher Ryan Bertiaux, MA, LPC, LAC, NCC
- Professional Counselor
- Pooler, GA
National Provider Identifier
1598418170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9636
- Practice address
- 1314 Watervista Ter
Pooler, GA 31322-5503 - Phone
- (843) 321-7881
- NPI assigned
- Feb 2, 2022
- Last updated
- Apr 8, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 016248 | GA | |
| Professional Counselor | 101YP2500X | 9636 | SC | Primary |
Addresses
Primary practice location
1314 Watervista Ter
Pooler, GA 31322-5503
Mailing address
1314 Watervista Ter
Pooler, GA 31322-5503
Phone (843) 321-7881
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9636 | SC | MD | Pharmacist |
| 016248 | GA | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1598418170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 WATERVISTA TER",
"city": "POOLER",
"state": "GA",
"postal_code": "313225503",
"telephone_number": "843-321-7881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 WATERVISTA TER",
"city": "POOLER",
"state": "GA",
"postal_code": "313225503",
"telephone_number": "843-321-7881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTIAUX",
"first_name": "CHRISTOPHER",
"middle_name": "RYAN",
"credential": "MA, LPC, LAC, NCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-02",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "016248",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "9636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.