Active NPI
Gwendolyn A. Berner, LCSW
- Clinical Social Worker
- Murphy, TX
National Provider Identifier
1780626564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S39975
- Practice address
- 1218 Terrace Mill Dr
Murphy, TX 75094-4168 - Phone
- (972) 533-7770
- Fax
- (972) 881-9728
- NPI assigned
- Jun 13, 2006
- Last updated
- Nov 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S39975 | TX | Primary |
Addresses
Primary practice location
1218 Terrace Mill Dr
Murphy, TX 75094-4168
Mailing address
1218 Terrace Mill Dr
Murphy, TX 75094-4168
Phone (972) 533-7770
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 274383 | Other | MHN | |
| 0046LJ | Other | TX | BLUECROSS BLUESHIELD |
| 254584000 | Other | MAGELLAN HEALTH SERVICES | |
| 058543 | Other | VALUEOPTIONS | |
| 1175126 | Other | CIGNA BEHAVIORAL HEALTH | |
| 4411595 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S39975 | TX | MD | Clinical Social Worker |
| 39975 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1780626564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 TERRACE MILL DR",
"city": "MURPHY",
"state": "TX",
"postal_code": "750944168",
"telephone_number": "972-533-7770",
"fax_number": "972-881-9728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 TERRACE MILL DR",
"city": "MURPHY",
"state": "TX",
"postal_code": "750944168",
"telephone_number": "972-533-7770",
"fax_number": "972-881-9728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNER",
"first_name": "GWENDOLYN",
"middle_name": "A.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "S39975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "274383",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "0046LJ",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH SERVICES",
"identifier": "254584000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "058543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "1175126",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4411595",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Murphy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.