MEDICARE: CYNTHIA R BERRIO-WILLIAMS LMHC

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	101YM0800X	Mental Health Counselor	LH60128084	WA

General Provider Information

NPI Number	:	1912297789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA R BERRIO-WILLIAMS LMHC

Provider Business Mailing Address
First Line	:	10532 NE 68TH ST
Second Line	:	SUITE D-101
City	:	KIRKLAND
State	:	WA
Zip	:	98033-7097
Country	:	US
Telephone Number	:	425-956-3604
Fax Number	:

Provider Business Practice Location Address
First Line	:	10532 NE 68TH ST
Second Line	:	SUITE D-101
City	:	KIRKLAND
State	:	WA
Zip	:	98033-7097
Country	:	US
Telephone Number	:	425-956-3604
Fax Number	:

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

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	04/13/2011

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