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General NPI Number Information
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NPI Number | 1750411419
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Entity Type | Individual
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Provider Name | BARBARA KOHLER BERRY LPC 0207 LISAC 0169
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 11011 S 48TH ST
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City | PHOENIX
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State | AZ
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Zip | 85044-1779
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Country | US
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Telephone | 480-838-1700
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Fax | 480-753-0060
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Provider Business Mailing Address
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Address Line | 1230 E LAGUNA DRIVE
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City | TEMPE
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State | AZ
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Zip | 85282
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Country | US
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Telephone | 480-838-1700
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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 | LISAC0169
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License Number State | AZ
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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 | LPC0207
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License Number State | AZ
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