Active NPI
Pennie Berry, MS, LPC, LMFT
- Mental Health Counselor
- Gravette, AR
National Provider Identifier
1902483993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P2305020
- Practice address
- 20655 Russell Corner Rd
Gravette, AR 72736-8955 - Phone
- (479) 366-2279
- NPI assigned
- Mar 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | M2305003 | AR | |
| Mental Health Counselor | 101YM0800X | P2305020 | AR | Primary |
Addresses
Primary practice location
20655 Russell Corner Rd
Gravette, AR 72736-8955
Mailing address
PO Box 285
Gravette, AR 72736-0285
Phone (479) 366-2279
Other practice location 1
12141 W Highway 72
Bentonville, AR 72712-9069
Phone (479) 366-2779
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P2305020 | AR | MD | Mental Health Counselor |
| M2305003 | AR | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Linnberry Wellness Center PLLC | Mental Health | Current | Accepting new patients |
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": "1616630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1902483993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 285",
"city": "GRAVETTE",
"state": "AR",
"postal_code": "727360285",
"telephone_number": "479-366-2279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20655 RUSSELL CORNER RD",
"city": "GRAVETTE",
"state": "AR",
"postal_code": "727368955",
"telephone_number": "479-366-2279"
}
],
"practiceLocations": [
{
"address_1": "12141 W Highway 72",
"address_purpose": "LOCATION",
"city": "Bentonville",
"state": "AR",
"postal_code": "727129069",
"country_code": "US",
"telephone_number": "479-366-2779",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERRY",
"first_name": "PENNIE",
"credential": "MS, LPC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-25",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AR",
"license": "M2305003",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P2305020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gravette, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.