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NPI 1104059443

NPI 1104059443 : LEAH BERRY LCMHCS, LCAS, CEDS-S : RALEIGH, NC

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General NPI Number Information
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    NPI Number           |    1104059443
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    Entity Type          |    Individual 
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    Provider Name        |    LEAH BERRY LCMHCS, LCAS, CEDS-S
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/03/2009
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    Last Update Date     |    02/14/2022
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Provider Practice Location Address
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    Address Line         |    8212 CREEDMOOR RD STE 101 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27613-1386
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    Country              |    US
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    Telephone            |    919-883-4478
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8212 CREEDMOOR RD STE 101 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27613-1386
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    Country              |    US
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    Telephone            |    919-883-4478
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    1396
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    7485
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    License Number State |    NC
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Taxonomy #3
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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