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General NPI Number Information
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NPI Number | 1821972589
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Entity Type | Organization
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Legal Business Name | BERBERICH COUNSELING AND COACHING
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 10927 UPLAND TERRACE DR
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City | LEBANON
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State | IL
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Zip | 62254-2335
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Country | US
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Telephone | 618-580-2796
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Fax |
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Provider Business Mailing Address
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Address Line | 10927 UPLAND TERRACE DR
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City | LEBANON
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State | IL
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Zip | 62254-2335
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Country | US
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Telephone | 618-580-2796
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CORY MATTHEW BERBERICH
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Credential | MA, LCPC
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Telephone | 618-580-2796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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