MRS. JACKIE MARIE BERGE (NPI# 1124632518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124632518 |
| Entity Type | Individual |
| Full Name | MRS. JACKIE MARIE BERGE |
| Practice Address |
3436 Mary Elder Rd Ne Olympia WA 98506-5050 |
| Mailing Address |
3336 Long Lake Dr Se Olympia WA 98503-4048 |
| Practice Telephone | 3605282590 |
| Mailing Telephone | 3604381411 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
RN00053908 | WA | Behavioral Health & Social Service Providers |
| Street Address |
3436 MARY ELDER RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760564934 | Cornelis Dehart Jr. | Psychologist | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2006-10-19 |
| 1205436094 | Angela M Sterling | Registered Nurse | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-10-29 |
| 1003415506 | Sarah K Augustine | Music Therapist | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-10-26 |
| 1922605211 | Marquesa Allen | Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-10-08 |
| 1528674660 | Roberto Gutierrez De La Cruz Jr. | Registered Nurse | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-09-22 |
| 1447864004 | Jeremy William Freier | Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-09-01 |
| 1780297317 | Whitney Elaine Grays | Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-08-24 |
| 1427660778 | Veronica Melissa Dupont-erickson | Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-08-18 |
| 1932710886 | Sheena Marie Royle | Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-08-13 |
| 1043829419 | Nisom Andrew Reyes Castillo | Rehabilitation Counselor | 3436 Mary Elder Rd Ne, Olympia, WA 98506-5050 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609494830 | Madison Samantha Johnson | Counselor | The Evergreen State College 2700 Evergreen Parkway Nw, Olympia, WA 98505-0001 | 2020-07-14 |
| 1710504972 | Ryan Erickson | Counselor | 2700 Evergreen Pkwy Nw Bldg I2731, Olympia, WA 98505-0001 | 2020-07-02 |
| 1669092151 | Emily Stephens | Counselor | 415 38th Ave Ne, Olympia, WA 98506-2417 | 2020-04-24 |
| 1003440405 | Mary Achol Bol | Counselor | 3436 Mary Elder Rd Ne # Rs, Olympia, WA 98506-5050 | 2020-02-25 |
| 1124651880 | Marie T Bendig | Counselor | 900 Fairview St Se, #b5, Olympia, WA 98501 | 2020-02-20 |
| 1134768799 | Living Sound Therapeutic Services, Pllc | Counselor | 729 Devoe St Se, Olympia, WA 98501 | 2019-12-31 |
| 1962047266 | Jeffrey Owen Nogler | Counselor | 1975 Olympia Ave Ne, Olympia, WA 98506-4643 | 2019-11-10 |
| 1720620636 | Heckler Integrative Psychiatric Care | Counselor | 2727 Westmoor Ct Sw Ste 100, Olympia, WA 98502-5754 | 2019-10-11 |
| 1073154936 | Michelle Rubbert | Counselor | 7722 Greenridge Loop Sw, Olympia, WA 98512-2347 | 2019-10-02 |
| 1295295749 | David Gervais | Counselor | 108 State Ave Nw Ste 25, Olympia, WA 98501-8249 | 2019-03-21 |
| Find all providers in OLYMPIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.