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General NPI Number Information
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NPI Number | 1316554439
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Entity Type | Individual
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Provider Name | STUART BERRY MSW, LISW
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Gender | Male
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 18 YORKSHIRE RD
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City | DELAWARE
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State | OH
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Zip | 43015-2846
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Country | US
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Telephone | 274-027-2389
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 174
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City | BELMONT
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State | VT
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Zip | 05730-0174
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Country | US
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Telephone | 740-272-3892
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0000794-SUPV
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License Number State | OH
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