Martha Phoenix Berry, M.A.,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401007192 Issued in MI

Practice address

31365 Coachlight LN
Bingham Farms, MI 48025-4403

Phone

(248) 646-3969

NPI assigned

Jun 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Martha Phoenix Professional 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

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

{
    "created_epoch": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213401600000",
    "number": "1679733430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31365 COACHLIGHT LN",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254403",
            "telephone_number": "248-646-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31365 COACHLIGHT LN",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254403",
            "telephone_number": "248-646-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MARTHA",
        "middle_name": "PHOENIX",
        "credential": "M.A.,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-14",
        "last_updated": "2008-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2684",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "PHOENIX",
            "credential": "M.A.,LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2008; 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.