Individual provider Active NPI

Gregory Berry, LMFT, CAS, PSYD

  • Marriage & Family Therapist
  • Mission Viejo, CA
National Provider Identifier
1982955076
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 25330 Issued in CA
Practice address
27405 Puerta Real
150
Mission Viejo, CA 92691-6314
Phone
(949) 716-7833
Fax
(949) 716-7833
NPI assigned
Sep 28, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAS - 3667 CA
Marriage & Family Therapist 106H00000X MFT 25330 CA Primary

Addresses

Primary practice location

27405 Puerta Real
150
Mission Viejo, CA 92691-6314

Mailing address

PO Box 80876
Rancho Santa Margarita, CA 92688-0876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240126001282 CA Practitioner - Marriage and Family Therapist 4789037649 Practice locations: Mission Viejo, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27405 Puerta Real
Suite 150
Mission Viejo, CA 92691-6366
Phone 94971678332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAS - 3667CAMDAddiction (Substance Use Disorder) Counselor
MFT 25330CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Associates, Inc. Past 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": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1982955076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80876",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926880876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27405 PUERTA REAL",
            "address_2": "150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916314",
            "telephone_number": "949-716-7833",
            "fax_number": "949-716-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "LMFT, CAS, PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-28",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CAS - 3667",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 25330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.