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NPI Code Detail

MEDICARE: BRYANA BERRY MSW

MEDICARE: BRYANA BERRY MSW
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
11041C0700XClinical Social WorkerC016381NC
21041C0700XClinical Social Worker0904015726VA

General Provider Information

NPI Number : 1841868304
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYANA BERRY MSW
Provider Business Mailing Address
First Line : 2401 GRAY GOOSE LOOP
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28306-7796
Country : US
Telephone Number : 910-835-6410
Fax Number :
Provider Business Practice Location Address
First Line : 711 EXECUTIVE PL
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28305-5193
Country : US
Telephone Number : 910-615-1623
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2021
Last Update Date : 05/04/2026

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