Provider Demographics
NPI:1790003945
Name:BERRYHILL, ELLERY COOK (ALC, ALMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELLERY
Middle Name:COOK
Last Name:BERRYHILL
Suffix:
Gender:F
Credentials:ALC, ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4906
Mailing Address - Country:US
Mailing Address - Phone:205-933-0338
Mailing Address - Fax:205-933-0343
Practice Address - Street 1:1900 14TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4906
Practice Address - Country:US
Practice Address - Phone:205-933-0338
Practice Address - Fax:205-933-0343
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1656A101Y00000X
ALA94106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor