Provider Demographics
NPI:1164741120
Name:BERRY, KIERA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIERA
Middle Name:ELIZABETH
Last Name:BERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KIERA
Other - Middle Name:ELIZABETH
Other - Last Name:SCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 S B ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6933
Mailing Address - Country:US
Mailing Address - Phone:805-735-4376
Mailing Address - Fax:
Practice Address - Street 1:101 S B ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6933
Practice Address - Country:US
Practice Address - Phone:805-735-4376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW613141041C0700X
COCSW.099237861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical