MEDICARE: DANIELLE MARIE BERES LMFT

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	106H00000X	Marriage & Family Therapist	1565	NC

General Provider Information

NPI Number	:	1861739070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MARIE BERES LMFT

Provider Business Mailing Address
First Line	:	1071 SEA EAGLE WATCH
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-8252
Country	:	US
Telephone Number	:	843-737-2521
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 SAM RITTENBERG BLVD STE 2011
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4631
Country	:	US
Telephone Number	:	843-737-2521
Fax Number	:

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

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	02/29/2024

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