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General NPI Number Information
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NPI Number | 1942744768
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Entity Type | Individual
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Provider Name | NILES ALEXANDER BERRY LMSW
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Gender | Male
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 5060 JACKSON RD STE D
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City | ANN ARBOR
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State | MI
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Zip | 48103-1867
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Country | US
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Telephone | 734-627-8001
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Fax | 734-433-1989
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Provider Business Mailing Address
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Address Line | 1904 WHITTIER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-1729
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Country | US
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Telephone | 260-223-2585
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Fax | 734-433-1989
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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 | 6801116118
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License Number State | MI
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