Mark Wynn Berger, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-26273 Issued in ID

Practice address

1002 Idaho St
Lewiston, ID 83501-1938

Phone

(208) 746-7661

NPI assigned

Sep 24, 2013

Last updated

Sep 24, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Beginnings Counseling and Support Services

  • Community/Behavioral Health Agency
  • Lewiston, ID
  • NPI 1417474859
  NPD (past)

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1720414634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011938",
            "telephone_number": "208-798-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011938",
            "telephone_number": "208-746-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "MARK",
        "middle_name": "WYNN",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "0660722707",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-26273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keriann Marie Bennett, PHARMD
• Randall Bennett
• Sara Light Bennett, LCPC
• Carrissa Bentley, LICSW
• Julie Benton, LMFT
• Nancy Berkheiser, M.D.
• Bertha Whitney (Miracle Ear Center)
• Jeffrey Carl Bickel, M.D
• Robert Biddle III
• Zadie Mazell Bielejec, ND

• Clinical Social Worker in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.