Harborside Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

HARBORSIDE PSYCHIATRY LLC

Practice address

213 E. Main Street
Rogue River, OR 97537-9100

Phone

(541) 714-5610

Fax

(541) 714-5611

NPI assigned

Jan 8, 2025

Last updated

Aug 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kacie Lauren Berry, PMHNPNPI 1225675218

Title

Owner

Phone

(541) 714-5610

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kacie Lauren Blackwell Berry, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rogue River, OR
  • NPI 1225675218
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1881404200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 E. MAIN STREET",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379100",
            "telephone_number": "541-714-5610",
            "fax_number": "541-714-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 E. MAIN STREET",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379100",
            "telephone_number": "541-714-5610",
            "fax_number": "541-714-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "KACIE",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-714-5610",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy Lynn Freitas, LMT
• Heather Marie Friend
• Edmund Glovinsky, D.O.
• Joshua Nelson Gruber, DDS
• Garvin J Hamilton, RPH
• Cora M Haze, P.A.
• Elizabeth Hirni, DO
• Jennifer Hook
• Wayne Allen Hopper, D.M.D.
• Kali Hull, LMT

• Psychiatry Physician in Rogue River, OR
• Providers in Rogue River, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.