Provider Demographics
NPI:1184671471
Name:BERKEY, PAULA MAVETTE (MA LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:MAVETTE
Last Name:BERKEY
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-5816
Mailing Address - Country:US
Mailing Address - Phone:803-731-4708
Mailing Address - Fax:803-612-1206
Practice Address - Street 1:900 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5816
Practice Address - Country:US
Practice Address - Phone:803-731-4708
Practice Address - Fax:803-612-1206
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2843106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist