Provider Demographics
NPI:1659836310
Name:BERIN INTEGRATIVE PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:BERIN INTEGRATIVE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, PSYD
Authorized Official - Phone:774-314-1215
Mailing Address - Street 1:1 WAYLAND AVE
Mailing Address - Street 2:UNIT 111 SOUTH
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906
Mailing Address - Country:US
Mailing Address - Phone:401-529-6909
Mailing Address - Fax:
Practice Address - Street 1:193 WATERMAN ST APT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4064
Practice Address - Country:US
Practice Address - Phone:774-314-1215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty