Provider Demographics
NPI:1275973695
Name:BERK, SHERRY W (MA)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:W
Last Name:BERK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3627 BARNWEILL ST
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7841
Mailing Address - Country:US
Mailing Address - Phone:813-380-7581
Mailing Address - Fax:
Practice Address - Street 1:3627 BARNWEILL ST
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7841
Practice Address - Country:US
Practice Address - Phone:813-380-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-29
Last Update Date:2013-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor