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General NPI Number Information
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NPI Number | 1336098672
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Entity Type | Individual
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Provider Name | EUGENE NATHANIEL BERRY MS
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Gender | Male
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 620 TERESA CT SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-2382
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Country | US
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Telephone | 505-688-7083
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 9TH AVE
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City | HONOLULU
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State | HI
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Zip | 96816-2417
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Country | US
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Telephone | 334-430-8198
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2026-0080
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License Number State | NM
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