Healthcare Provider Details

I. General information

NPI: 1689850976
Provider Name (Legal Business Name): TAM'MEKA BERRY LPC-SAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 W SAINT PAUL AVE UNIT 197
MILWAUKEE WI
53201-2211
US

IV. Provider business mailing address

345 W SAINT PAUL AVE UNIT 197
MILWAUKEE WI
53201-2211
US

V. Phone/Fax

Practice location:
  • Phone: 414-368-0256
  • Fax: 414-413-4542
Mailing address:
  • Phone: 414-368-0256
  • Fax: 414-413-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8-226
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: