Provider Demographics
NPI:1326144395
Name:BERRY, DARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13575 58TH ST N
Mailing Address - Street 2:SUITE 187
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3740
Mailing Address - Country:US
Mailing Address - Phone:800-632-6074
Mailing Address - Fax:
Practice Address - Street 1:56 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1205
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0033621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002920Medicaid
NC2873210BMedicare PIN
NCQ420960281Medicare PIN