Active NPI
Cole Sebastian Berry
- Mental Health Counselor
- La Selva BCH, CA
National Provider Identifier
1619101243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 360 Whiskey Hill Rd
La Selva BCH, CA 95076-8521 - Phone
- (831) 724-9333
- NPI assigned
- May 11, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
360 Whiskey Hill Rd
La Selva BCH, CA 95076-8521
Mailing address
360 Whiskey Hill Rd
La Selva BCH, CA 95076-8521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ91892Z | Other | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Encompass Community Services | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Watsonville, CA
- NPI 1497971436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312934400000",
"number": "1619101243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 WHISKEY HILL RD",
"city": "LA SELVA BCH",
"state": "CA",
"postal_code": "950768521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 WHISKEY HILL RD",
"city": "LA SELVA BCH",
"state": "CA",
"postal_code": "950768521",
"telephone_number": "831-724-9333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "COLE",
"middle_name": "SEBASTIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-11",
"last_updated": "2011-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
"identifier": "ZZZ91892Z",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in La Selva BCH, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.