MEDICARE: MRS. ERIN M BERK LPC, ATR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist	05-066	NC
2	101YP2500X	Professional Counselor	C3705	OR

General Provider Information

NPI Number	:	1508921941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN M BERK LPC, ATR

Provider Business Mailing Address
First Line	:	1001 SE 50TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97215-2603
Country	:	US
Telephone Number	:	971-222-9290
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 SE 12TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-2513
Country	:	US
Telephone Number	:	971-222-9290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	04/10/2023

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