MEDICARE: BERKANA COLLECTIVE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225763675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKANA COLLECTIVE, LLC

Provider Business Mailing Address
First Line	:	108 AIRPORT RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-2607
Country	:	US
Telephone Number	:	706-961-4782
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 AIRPORT RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-2607
Country	:	US
Telephone Number	:	706-961-4782
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	CARRIE MORRIS
Credential	:	LMFT
Telephone Number	:	706-961-4782

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	06/23/2023

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Directions to “BERKANA COLLECTIVE, LLC ” Practice Location

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