Individual provider Active NPI

Karen C Berg, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1831248707
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07850 Issued in MD
Practice address
5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974
Phone
(410) 931-9280
Fax
(410) 931-6694
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 07850 MD Primary

Addresses

Primary practice location

5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974

Mailing address

5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974
Phone (410) 931-9280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240125004612 MA Practitioner - Clinical Social Worker 5799853602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7850MDMDProsthodontist
07850MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC Clinical CurrentSince Jan 1, 2024 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1831248707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 CAMPBELL BLVD",
            "address_2": "SUITE H",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365974",
            "telephone_number": "410-931-9280",
            "fax_number": "410-931-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 CAMPBELL BLVD",
            "address_2": "SUITE H",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365974",
            "telephone_number": "410-931-9280",
            "fax_number": "410-931-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "KAREN",
        "middle_name": "C",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.