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NPI Code Detail

MEDICARE: ANGELA KESSLER BERRY LCSW

MEDICARE: ANGELA KESSLER BERRY LCSW
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
11041C0700XClinical Social WorkerC006497NC

General Provider Information

NPI Number : 1922293257
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA KESSLER BERRY LCSW
Provider Business Mailing Address
First Line : 7211 CONIFER CIR
Second Line :
City : INDIAN TRAIL
State : NC
Zip : 28079-9528
Country : US
Telephone Number : 704-254-6450
Fax Number :
Provider Business Practice Location Address
First Line : 400 N CHURCH ST
Second Line :
City : MONROE
State : NC
Zip : 28112-4804
Country : US
Telephone Number : 704-254-6450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2007
Last Update Date : 11/26/2014

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