Healthcare Provider Details

I. General information

NPI: 1023866639
Provider Name (Legal Business Name): LAUREN M. BERRILL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 MAMARONECK AVE
WHITE PLAINS NY
10605-2523
US

IV. Provider business mailing address

785 MAMARONECK AVE
WHITE PLAINS NY
10605-2523
US

V. Phone/Fax

Practice location:
  • Phone: 914-597-2332
  • Fax:
Mailing address:
  • Phone: 914-597-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number026210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: