Provider Demographics
NPI:1578225728
Name:BERRY, NATALIE FARID (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:FARID
Last Name:BERRY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3058 BARDSTOWN RD # 1285
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3020
Mailing Address - Country:US
Mailing Address - Phone:502-509-3609
Mailing Address - Fax:
Practice Address - Street 1:3058 BARDSTOWN RD # 1285
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3020
Practice Address - Country:US
Practice Address - Phone:502-509-3609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical