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General NPI Number Information
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NPI Number | 1811212061
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Entity Type | Individual
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Provider Name | DIANE MARIE BERICK LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 230 S COURT ST SUITE 5
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City | MEDINA
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State | OH
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Zip | 44256-2275
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Country | US
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Telephone | 330-723-7977
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Fax | 330-725-5177
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Provider Business Mailing Address
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Address Line | 2101 FRONT ST STE 106
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-3251
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Country | US
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Telephone | 330-836-8090
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Fax | 330-794-5912
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E 0000697
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License Number State | OH
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