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General NPI Number Information
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NPI Number | 1730637489
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Entity Type | Organization
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Legal Business Name | JAMES C. BERRY, PHD, LLC
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 09/12/2016
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Provider Practice Location Address
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Address Line | 3425 S CLARKSON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2811
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Country | US
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Telephone | 303-933-2327
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Fax | 720-870-0334
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Provider Business Mailing Address
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Address Line | 3425 S CLARKSON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2811
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Country | US
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Telephone | 303-933-2327
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Fax | 720-870-0334
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES C BERRY
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Credential | PHD
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Telephone | 303-933-2327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY0001667
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License Number State | CO
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