Gwendolyn D Bergstrom, LIMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1154 Issued in NE

Practice address

720 N Jeffers St
North Platte, NE 69101-3021

Phone

(308) 520-4863

NPI assigned

Jan 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Homestead Counseling LLC

  • Mental Health Counselor
  • North Platte, NE
  • NPI 1821844200
  NPD Authorized official

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1629256706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6459 S HOMESTEAD RD",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016979",
            "telephone_number": "308-520-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N JEFFERS ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691013021",
            "telephone_number": "308-520-4863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6459 S Homestead Rd",
            "address_purpose": "LOCATION",
            "city": "North Platte",
            "state": "NE",
            "postal_code": "691016979",
            "country_code": "US",
            "telephone_number": "308-520-4863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "GWENDOLYN",
        "middle_name": "D",
        "credential": "LIMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Benyoung
• Cynthia Kay Berg
• Kaleigh Anne Berg
• Tracey Renee' Berg
• Jackie Berglund
• Kevin Jay Bergstrom
• Janet Elizabeth Bernard, M.D.
• Kassandra Marie Bertholf, DC
• Chrytal Bethke
• Michael James Bianco, M.D.

• Mental Health Counselor in North Platte, NE
• Providers in North Platte, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.