Provider Demographics
NPI:1285042465
Name:BERRIE, KAREN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:BERRIE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 TAVISTOCK
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-4027
Mailing Address - Country:US
Mailing Address - Phone:201-906-9789
Mailing Address - Fax:
Practice Address - Street 1:385 TAVISTOCK
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-4027
Practice Address - Country:US
Practice Address - Phone:201-906-9789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00334300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6495401Medicaid