Jill Bergen

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6851-125 Issued in WI

Practice address

7900 W Burleigh St
Milwaukee, WI 53222-4917

Phone

(262) 598-1392

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Outreach Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1710032669
  Medicare reassignment NPD
• Outreach Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1558231563
  NPD
• Quality Addiction Management Inc

  • Methadone Clinic
  • Kenosha, WI
  • NPI 1184354979
  NPD (past)
• Quality Addiction Management Inc

  • Methadone Clinic
  • Green Bay, WI
  • NPI 1629282470

  Addiction (Substance Use Disorder)

  NPD (past)
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1801245840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532224917",
            "telephone_number": "414-435-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532224917",
            "telephone_number": "262-598-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16240-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6851-125",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "6851-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Berg, LPC
• Marie Berg, DPT
• Richard C Berg
• Ryan Berg, M.D.
• Michael Bergemann
• Robin C Raber Bergeon, LCSW
• Berger and Burrow Enterprises, Inc
• Bonnie Berger-Durnbaugh, M.D.
• Jessica Ann Berger-Martinez, APSW
• Allison Marie Berger

• Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.