Individual provider Active NPI

Sandra K Berg, LPC LCPC

  • Professional Counselor
  • Wichita, KS
National Provider Identifier
1972587087
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
329 Issued in KS
Practice address
221 S Broadway St
Suite 410
Wichita, KS 67202-4228
Phone
(316) 350-7813
NPI assigned
Dec 1, 2005
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 824 KS
Professional Counselor 101YP2500X 329 KS Primary

Addresses

Primary practice location

221 S Broadway St
Suite 410
Wichita, KS 67202-4228

Mailing address

221 S Broadway St
Suite 410
Wichita, KS 67202-4228
Phone (316) 350-7813

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

LicenseStateTypeSpecialty
329KSMDProfessional Counselor
824KSMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1972587087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S BROADWAY ST",
            "address_2": "SUITE 410",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024228",
            "telephone_number": "316-350-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S BROADWAY ST",
            "address_2": "SUITE 410",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024228",
            "telephone_number": "316-350-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "LPC LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "824",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.