Mary Ellen Rae Bertling-Safford, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401007799 Issued in MI

Practice address

1034 Lookout RDG
Mesquite, NV 89034-1195

Phone

(616) 920-0823

Fax

(866) 721-6199

NPI assigned

Jun 17, 2008

Last updated

Feb 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mary Ellen Rae Bertling Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Michigan Emdr Therapy and Consulting PLLC

  • Professional Counselor
  • Mesquite, NV
  • NPI 1508228966
  NPD Authorized official

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1639330285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 LOOKOUT RDG",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890341195",
            "telephone_number": "616-920-0823",
            "fax_number": "866-721-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 LOOKOUT RDG",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890341195",
            "telephone_number": "616-920-0823",
            "fax_number": "866-721-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTLING-SAFFORD",
        "first_name": "MARY ELLEN",
        "middle_name": "RAE",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NV",
            "license": "CP1132",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401007799",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CP1132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "BERTLING",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Mesquite, NV
• Providers in Mesquite, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.