Provider Demographics
NPI:1114461498
Name:BERINGER, AUDREY MAE (LPC/MHSP)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:MAE
Last Name:BERINGER
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ALFALFA LN
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-3170
Mailing Address - Country:US
Mailing Address - Phone:423-483-4075
Mailing Address - Fax:
Practice Address - Street 1:600 E UNAKA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4035
Practice Address - Country:US
Practice Address - Phone:423-483-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3816101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional