Provider Demographics
NPI:1710042379
Name:BERRY, MONICA NICOLE (MA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:NICOLE
Last Name:BERRY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SCHOOL ST
Mailing Address - Street 2:UNIT 207
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-3271
Mailing Address - Country:US
Mailing Address - Phone:781-925-1581
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 216
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-331-7866
Practice Address - Fax:781-331-7976
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health