| Kimberly Berry LPC LLC | |
|
187 Belmont Dr Dothan AL 36305-6500 | |
| (334) 671-1280 | |
| Not Available |
| Full Name | Kimberly Berry LPC LLC |
|---|---|
| Speciality | Counselor |
| Location | 187 Belmont Dr, Dothan, Alabama |
| Authorized Official Name and Position | Kimberly Berry (OWNER) |
| Authorized Official Contact | 3346188947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Berry LPC LLC 187 Belmont Dr Dothan AL 36305-6500 Ph: (334) 671-1280 | Kimberly Berry LPC LLC 187 Belmont Dr Dothan AL 36305-6500 Ph: (334) 671-1280 |
| NPI Number | 1720837024 |
|---|---|
| Provider Enumeration Date | 05/17/2024 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 1153868633 |
|---|---|
| Medicare Enrollment ID | O20240801002248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720837024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Primary |
| Provider Name | Kimberly Berry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275789158 PECOS PAC ID: 2769929249 Enrollment ID: I20240801002471 |
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