Healthcare Provider Details

I. General information

NPI: 1255113445
Provider Name (Legal Business Name): JESSICA ANN BERRYHILL LCSW LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA ANN BOATRIGHT

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9812 SLIDE RD
LUBBOCK TX
79424-5781
US

IV. Provider business mailing address

2215 NASHVILLE AVE
LUBBOCK TX
79410-1105
US

V. Phone/Fax

Practice location:
  • Phone: 806-725-1000
  • Fax: 806-783-9374
Mailing address:
  • Phone: 806-725-5228
  • Fax: 806-723-6532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15858
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number68220
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: