Healthcare Provider Details

I. General information

NPI: 1013689116
Provider Name (Legal Business Name): KATERI BERASI PSYD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N 12TH ST STE 817
BROOKLYN NY
11249-1002
US

IV. Provider business mailing address

162 SAINT NICHOLAS AVE APT 2R
BROOKLYN NY
11237-4410
US

V. Phone/Fax

Practice location:
  • Phone: 149-791-7319
  • Fax:
Mailing address:
  • Phone: 914-522-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KATERI BERASI
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 914-979-1731