Ronville S Bertie, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH17081 Issued in FL

Practice address

3015 Parental Home Rd
Jacksonville, FL 32216-5768

Phone

(904) 720-0002

Fax

(904) 724-8513

NPI assigned

May 14, 2018

Sex

Male

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

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  NPD
• Youth Crisis Center, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1770884686
  NPD (past)

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1801386065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165768",
            "telephone_number": "904-720-0002",
            "fax_number": "904-724-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165768",
            "telephone_number": "904-720-0002",
            "fax_number": "904-724-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTIE",
        "first_name": "RONVILLE",
        "middle_name": "S",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH17081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmin Mariah Berry
• Robyn Elizabeth Berryman, NNP-BC, MSN
• Philip John Bert
• Clarissa Bertha
• Marsha F Bertholf, M.D.
• Suzanne Michele Bertisch, M.D., M.P.H.
• Leah Bertoch
• Sara Cummings Bertoch, PHD
• Giancarlo Bertozzi, MD
• Caroline Suzanne Bertsch, MS, CGC

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.