Provider Demographics
NPI:1275162307
Name:BERRING INVESTMENT GROUP, LLC
Entity Type:Organization
Organization Name:BERRING INVESTMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRING
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-988-5211
Mailing Address - Street 1:4612 PLOVER ST NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516
Mailing Address - Country:US
Mailing Address - Phone:253-988-5211
Mailing Address - Fax:
Practice Address - Street 1:4313 6TH AVE SE STE C
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1072
Practice Address - Country:US
Practice Address - Phone:253-988-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health