Provider Demographics
NPI:1376235614
Name:EMILY L. BERRY, BEHAVIORAL CONSULTANTS
Entity Type:Organization
Organization Name:EMILY L. BERRY, BEHAVIORAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:LAWSON
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-403-1724
Mailing Address - Street 1:1818 HILLCREST STREET
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417
Mailing Address - Country:US
Mailing Address - Phone:616-403-1724
Mailing Address - Fax:
Practice Address - Street 1:113 W. SAVIDGE STREET
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49456
Practice Address - Country:US
Practice Address - Phone:616-209-8288
Practice Address - Fax:313-569-5969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty