MEDICARE: ELIZABETH LEE BERRY MSE

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	7949-226	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952043259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEE BERRY MSE

Provider Business Mailing Address
First Line	:	800 WISCONSIN ST
Second Line	:	BLDG D02 STE 408
City	:	EAU CLAIRE
State	:	WI
Zip	:	54703-3588
Country	:	US
Telephone Number	:	715-598-7003
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 WISCONSIN ST
Second Line	:	BLDG D02 STE 408
City	:	EAU CLAIRE
State	:	WI
Zip	:	54703-3588
Country	:	US
Telephone Number	:	715-598-7003
Fax Number	:

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

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	03/17/2026

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