Provider Demographics
NPI:1366686461
Name:BERRIO, HECTOR R (LMHC)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:R
Last Name:BERRIO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 W 1ST ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3222
Mailing Address - Country:US
Mailing Address - Phone:239-332-8009
Mailing Address - Fax:239-332-4977
Practice Address - Street 1:2180 W 1ST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3222
Practice Address - Country:US
Practice Address - Phone:239-332-8009
Practice Address - Fax:239-332-4977
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 8207OtherPROFESSIONAL LICENSE