Alexandra Hailey Bergeson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHCA.MC.61087164 Issued in WA

Practice address

1305 Tacoma Ave S
Tacoma, WA 98402-1903

Phone

(253) 396-5800

NPI assigned

Aug 25, 2020

Last updated

Aug 25, 2020By the provider in NPPES

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

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1669085197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 TACOMA AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 TACOMA AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021903",
            "telephone_number": "253-396-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGESON",
        "first_name": "ALEXANDRA",
        "middle_name": "HAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.61087164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nachole M Berg, LMP
• Randi Marie Berg, ARNP
• Samantha J Berger, LMT
• Steven M Berger
• Chelsea Requijo Bergeron
• Jason R Berglund, ATC
• Lee J Bergmann, PA-C
• Marjorie A Bergsma, PA-C
• James R. Bergstrom, ARNP
• Trina Bergstrom, COTA/L

• Mental Health Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.