MEDICARE: MRS. SAUNDRA K BERRY LMFT, LCSW

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	39001620A	IN
2	106H00000X	Marriage & Family Therapist	35-001455	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000311557	OTHER	IN	ANTHEM BCBS
2	7766116	OTHER	IN	AETNA

General Provider Information

NPI Number	:	1962581124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAUNDRA K BERRY LMFT, LCSW

Provider Business Mailing Address
First Line	:	7700 N MERIDIAN ST
Second Line	:	CFLM
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-3652
Country	:	US
Telephone Number	:	317-252-5518
Fax Number	:	317-259-5718

Provider Business Practice Location Address
First Line	:	7700 N MERIDIAN ST
Second Line	:	CFLM
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-3652
Country	:	US
Telephone Number	:	317-252-5518
Fax Number	:	317-259-5718

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	09/11/2025

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