MEDICARE: NOAH BERRY

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	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1235093873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH BERRY

Provider Business Mailing Address
First Line	:	7684 COPPERSHELL ST
Second Line	:
City	:	BLACKLICK
State	:	OH
Zip	:	43004-7104
Country	:	US
Telephone Number	:	614-632-5246
Fax Number	:

Provider Business Practice Location Address
First Line	:	7684 COPPERSHELL ST
Second Line	:
City	:	BLACKLICK
State	:	OH
Zip	:	43004-7104
Country	:	US
Telephone Number	:	614-632-5246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ NOAH BERRY ” Practice Location

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