Healthcare Provider Details

I. General information

NPI: 1275932436
Provider Name (Legal Business Name): PATRICIA BERRY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA ANN MAEZ

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 OFFICE COURT DR
SANTA FE NM
87507-4929
US

IV. Provider business mailing address

1243 CALLE INEZ
SANTA FE NM
87507-7193
US

V. Phone/Fax

Practice location:
  • Phone: 505-310-4764
  • Fax:
Mailing address:
  • Phone: 505-377-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: