Individual provider Active NPI

Elizabeth Carleton Berk, LICSW

  • Mental Health Counselor
  • Westford, MA
National Provider Identifier
1609965391
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1025453 Issued in MA
Practice address
11 Casie LN
Westford, MA 01886-4062
Phone
(978) 413-9445
NPI assigned
Oct 12, 2006
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1025453 MA Primary

Addresses

Primary practice location

11 Casie LN
Westford, MA 01886-4062

Mailing address

11 Casie LN
Westford, MA 01886-4062
Phone (978) 413-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061115000212 MA Practitioner - Clinical Social Worker 4082612619 Practice locations: Westford, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11 Casie LN
Westford, MA 01886-4062
Phone (978) 413-9445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025453MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inger M Maier PHD Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1609965391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CASIE LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018864062",
            "telephone_number": "978-413-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CASIE LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018864062",
            "telephone_number": "978-413-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERK",
        "first_name": "ELIZABETH",
        "middle_name": "CARLETON",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1025453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

Verify at the official NPI Registry.