Provider Demographics
NPI:1679469449
Name:BERICK, MICHAEL RYAN (AUD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RYAN
Last Name:BERICK
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 CONCORD ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2269
Mailing Address - Country:US
Mailing Address - Phone:419-571-6742
Mailing Address - Fax:
Practice Address - Street 1:395 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1542
Practice Address - Country:US
Practice Address - Phone:216-998-3383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02596231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist