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General NPI Number Information
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NPI Number | 1508194218
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Entity Type | Individual
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Provider Name | AMIE M BERRY LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 4651 SALISBURY ROAD SOUTH 4TH FLOOR, SUITE 428
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5506
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Country | US
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Telephone | 904-748-9106
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Fax | 888-244-7481
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Provider Business Mailing Address
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Address Line | 13820 OLD ST. AUGUSTINE ROAD SUITE 113-166
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5506
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Country | US
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Telephone | 904-748-9106
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Fax | 888-247-7481
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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 | SW9352
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | SW9352
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License Number State | FL
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