Healthcare Provider Details

I. General information

NPI: 1689203549
Provider Name (Legal Business Name): HEATHER MILLS BERRY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NEUMIND WELLNESS GROUP 2113 RUBY RED BLVD SUITE D
CLERMONT FL
34714
US

IV. Provider business mailing address

2113 RUBY RED BLVD STE D
CLERMONT FL
34714-6115
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-0573
  • Fax:
Mailing address:
  • Phone: 352-394-0573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMT4289
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT3281
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4289
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: