Individual provider Active NPI

Thomas Robert Berry, PHD

  • Counseling Psychologist
  • Columbia, MO
National Provider Identifier
1942004676
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
025009592 Issued in MO
Practice address
2600 Forum Blvd Ste G
Columbia, MO 65203-6343
Phone
(573) 239-9915
NPI assigned
Apr 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 025009592 MO Primary

Addresses

Primary practice location

2600 Forum Blvd Ste G
Columbia, MO 65203-6343

Mailing address

2600 Forum Blvd Ste G
Columbia, MO 65203-6343
Phone (573) 239-9915

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
025009592MOMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anxiety & Depression Clinic of Columbia CurrentSince Apr 6, 2025 Accepting new patients

Locations

2600 Forum Blvd
Ste G
Columbia, MO 65203
Phone (573) 239-9915

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": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1942004676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FORUM BLVD STE G",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036343",
            "telephone_number": "573-239-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FORUM BLVD STE G",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036343",
            "telephone_number": "573-239-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "025009592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.