Active NPI
Jesus Berrio
- Addiction (Substance Use Disorder) Counselor
- Providence, RI
National Provider Identifier
1891209045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDP00716
- Practice address
- 530 N Main St
Providence, RI 02904-5762 - Phone
- (401) 276-4100
- NPI assigned
- Nov 27, 2017
- Last updated
- Nov 27, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDP00716 | RI | Primary |
Addresses
Primary practice location
530 N Main St
Providence, RI 02904-5762
Mailing address
530 N Main St
Providence, RI 02904-5762
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDP00716 | RI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511740800000",
"number": "1891209045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045762",
"telephone_number": "401-276-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRIO",
"first_name": "JESUS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-27",
"last_updated": "2017-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "RI",
"license": "CDP00716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.