ANTHONY L BERARDI, PHD PC (NPI# 1437421435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437421435 |
| Entity Type | Organization |
| Organization Name | ANTHONY L BERARDI, PHD PC |
| Practice Address |
300 S Saint Louis Blvd Suite 202 South Bend IN 46617-3043 |
| Practice Telephone | 5742321405 |
| Practice Fax Number | 5742320124 |
| Mailing Telephone | 5742321405 |
| Mailing Fax Number | 5742320124 |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2016-08-04 |
| Authorized Official Name | DR. ANTHONY LOUIS BERARDI (PRESIDENT) |
| Authorized Official Telephone | 5742321405 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
6301006300 | MI | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
20010290A | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201052000 A | 05 | |
| IN | MEDICARE PTAN | M100064411 | 01 |
| Street Address |
300 S SAINT LOUIS BLVD SUITE 202 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316995095 | Anthony Louis Berardi | Psychologist | 300 S Saint Louis Blvd, Suite 202, South Bend, IN 46617-3043 | 2006-05-04 |
| 1164968053 | Laura A Happ | Social Worker | 300 S Saint Louis Blvd, Suite 200, South Bend, IN 46617-3043 | 2017-01-16 |
| 1336698943 | New Avenues Inc. | Social Worker | 300 S Saint Louis Blvd, Ste 200, South Bend, IN 46617-3043 | 2016-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003374422 | National Youth Advocate Program, Inc | Clinic/Center | 3631 Edison Rd, South Bend, IN 46615-3715 | 2019-03-05 |
| 1750411872 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-03-07 |
| 1376691154 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-01-08 |
| 1174671952 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093676 | Life Skills Unlimited LLC | Clinic/Center | 6433 E Washington St Ste 185, Indianapolis, IN 46219-6624 | 2020-11-06 |
| 1083214159 | Amber Kinney, LLC | Clinic/Center | 623 S Washington St Apt A, Bloomington, IN 47401-5645 | 2020-10-28 |
| 1710585997 | Bloomington Neurofeedback | Clinic/Center | 1905 S Liberty Dr, Bloomington, IN 47403-5146 | 2020-10-11 |
| 1255943346 | Reality Counseling LLC | Clinic/Center | 5610 Crawfordsville Rd Ste 605, Indianapolis, IN 46224-3715 | 2020-08-19 |
| 1326658568 | Jennifer Steinmetz Msw LLC | Clinic/Center | 115 N College Ave Ste 225, Bloomington, IN 47404-4099 | 2020-08-03 |
| 1376161810 | North Clark Behavioral Health LLC | Clinic/Center | 2100 Market St Ste 200, Charlestown, IN 47111-8507 | 2020-07-10 |
| 1265068084 | Wellness Etc LLC | Clinic/Center | 1133 W Mill Rd Ste 200, Evansville, IN 47710-3877 | 2020-03-13 |
| 1114553948 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 720 N Marr Rd Ste A, Columbus, IN 47201-6660 | 2020-03-12 |
| 1376174904 | Karen Brosius LLC | Clinic/Center | 901 S Rogers St Ste 201, Bloomington, IN 47403-4760 | 2020-02-02 |
| 1396385886 | Urban Act Academy | Clinic/Center | 1250 E Market St, Indianapolis, IN 46202-3831 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
Please comment or provide details below to improve the information on ANTHONY L BERARDI, PHD PC.
| 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.