DR. KELLY C BERG (NPI# 1649610270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649610270 |
| Entity Type | Individual |
| Full Name | DR. KELLY C BERG |
| Credential | PH.D. |
| Practice Address |
2230 Como Ave Saint Paul MN 55108-1720 |
| Mailing Address |
5925 Ewing Ave S Edina MN 55410-2737 |
| Practice Telephone | 6128042120 |
| Mailing Telephone | 6128042120 |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2013-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
5595 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144667536 | Kelly Nicole Berg | Social Worker | 6012 N Kenmore Ave, 1c, Chicago, IL 60660-5014 | 2013-05-27 |
| Street Address |
2230 COMO AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55108-1720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841204989 | Brian Stawarz | Psychologist | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2006-07-27 |
| 1568069532 | Rachel Ruth Onusko | Student in an Organized Health Care Education/Training Program | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2020-10-02 |
| 1265044390 | Elsie Ann Myers | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2020-08-19 |
| 1962014209 | Ashley Annette Snoke | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2020-08-18 |
| 1053920041 | Anna Catherine Bishop | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2020-07-27 |
| 1295359727 | Lacey Raser | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2020-06-01 |
| 1356992838 | Abigail Hough | Counselor | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2019-09-25 |
| 1427608579 | Emma Margaret Lankey | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2019-09-19 |
| 1669021671 | Emily M Vanderbrink | Dietitian, Registered | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2019-09-11 |
| 1336797687 | Emileah Most | Marriage & Family Therapist | 2230 Como Ave, Saint Paul, MN 55108-1720 | 2019-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490677 | Kyle Leonard Bernier | Student in an Organized Health Care Education/Training Program | 1295 Bandana Blvd W, Suite 210, St. Paul, MN 55108 | 2019-07-25 |
| 1356870778 | Kathleen Louise Kocon | Marriage & Family Therapist | 2230 Como Ave., Saint Paul, MN 55108 | 2017-06-08 |
| 1871965830 | Jill Hansen | Specialist | 1449 Clevland Ave N, The Emily Program, Saint Paul, MN 55108 | 2015-10-29 |
| 1871821140 | Angela Joyce Anderson | Speech-Language Pathologist | 2266 Hillside Avenue, Saint Paul, MN 55108 | 2009-11-25 |
| 1265769418 | Dakota Baker | Counselor | 1360 Energy Park Drive Suite 340, St. Paul, MN 55108 | 2009-11-09 |
| 1255583449 | Suzanne Elizabeth Trunnell | Nurse Practitioner | 1020 Bandana Blvd. W, Aspen Medical Group--bandana Square, St. Paul, MN 55108 | 2008-10-21 |
| 1982851358 | Kimberly Joy Bahma | Pharmacist | 1295 Bandana Blvd, Suite 335, Saint Paul, MN 55108 | 2008-08-27 |
| 1952566093 | Caring Professionals Homecare, LLC | Home Health | 1543 Como Ave Ste 101, Saint Paul, MN 55108 | 2008-07-28 |
| 1700077344 | Archana Mani | Dentist | 1021 Bandana Blvd E Ste 121, Saint Paul, MN 55108 | 2007-08-08 |
| 1457554735 | Catherine Lawrence Scharlau | Psychologist | 1295 Bandana Blvd. North, Aspen Medical Group-behavioral Health, St. Paul, MN 55108 | 2007-06-06 |
| Find all providers in zip 55108 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134732514 | Colleen Cashen | Psychologist | 1341 Cleveland Ave S, Saint Paul, MN 55116-2653 | 2020-08-26 |
| 1124597133 | Take Flight Counseling Services LLC | Psychologist | 1821 University Ave W Ste S303, Saint Paul, MN 55104-2813 | 2018-11-19 |
| 1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
| 1851845267 | Sharon Black | Psychologist | 1774 Sheridan Ave, Saint Paul, MN 55116-2730 | 2016-08-15 |
| 1457760316 | Mera Kachgal | Psychologist | 121 7th Pl E Ste 300, Dds, Saint Paul, MN 55101-2116 | 2014-08-05 |
| 1316230238 | Psybiz, Inc. | Psychologist | 155 Wabasha St S Ste 122, Saint Paul, MN 55107-1822 | 2011-05-25 |
| 1093006215 | (albina) Louise Hiniker | Psychologist | 1811 Bayard Ave, Saint Paul, MN 55116-1437 | 2011-04-21 |
| 1780992479 | Michael V. Desanctis, Phd, Abpp, Licensed Psychologist Pllc | Psychologist | 413 Wacouta St Ste 550, Saint Paul, MN 55101-1645 | 2010-09-16 |
| 1306171889 | Renee Fredrickson | Psychologist | 1248 Bucher Ave, Saint Paul, MN 55126-8602 | 2009-10-16 |
| 1689826158 | Sheila Maland | Psychologist | 311 Ramsey St Ste 205, Saint Paul, MN 55102-2323 | 2008-10-16 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55108 |
Please comment or provide details below to improve the information on DR. KELLY C BERG.
| 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.