Provider Demographics
NPI:1427564574
Name:BERRIOS, MARIA C
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SPARKS PLACE
Mailing Address - Street 2:
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070
Mailing Address - Country:US
Mailing Address - Phone:856-376-3867
Mailing Address - Fax:856-376-3867
Practice Address - Street 1:116 N 2ND ST STE 102
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1601
Practice Address - Country:US
Practice Address - Phone:856-338-9300
Practice Address - Fax:856-338-9301
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00002600101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)