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General NPI Number Information
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NPI Number | 1982955076
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Entity Type | Individual
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Provider Name | GREGORY BERRY LMFT, CAS, PSYD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 27405 PUERTA REAL 150
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6314
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Country | US
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Telephone | 949-716-7833
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Fax | 949-716-7833
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Provider Business Mailing Address
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Address Line | PO BOX 80876
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-0876
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Country | US
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Telephone |
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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 | CAS - 3667
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT 25330
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License Number State | CA
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