Provider Demographics
NPI:1093722746
Name:BERRY, FRANKLIN MORRIS SR (PH D)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:MORRIS
Last Name:BERRY
Suffix:SR
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7585 E REDFIELD RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6938
Mailing Address - Country:US
Mailing Address - Phone:602-310-9028
Mailing Address - Fax:602-354-6938
Practice Address - Street 1:7585 E REDFIELD RD
Practice Address - Street 2:SUITE 211
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6938
Practice Address - Country:US
Practice Address - Phone:602-310-9028
Practice Address - Fax:602-354-4402
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1313103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ043468OtherMANAGED HEALTH NETWORK AZ
AZAZ0608270OtherBLUE CROSS BS OF AZ
AZ162131Medicaid
AZ1313PHDMedicare ID - Type Unspecified