Provider Demographics
NPI:1033639695
Name:BERRY, CHERYL A (LMSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:BERRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 CAMPUS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-9533
Mailing Address - Country:US
Mailing Address - Phone:989-839-3500
Mailing Address - Fax:989-839-3344
Practice Address - Street 1:4611 CAMPUS RIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-9533
Practice Address - Country:US
Practice Address - Phone:989-839-3500
Practice Address - Fax:989-839-3344
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010628361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical