Provider Demographics
NPI:1972077212
Name:BERRY, ZENIA QUIZETTE (LLBSW)
Entity Type:Individual
Prefix:MRS
First Name:ZENIA
Middle Name:QUIZETTE
Last Name:BERRY
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:MS
Other - First Name:ZENIA
Other - Middle Name:QUIZETTE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25057 OAKBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2519
Mailing Address - Country:US
Mailing Address - Phone:313-674-7426
Mailing Address - Fax:
Practice Address - Street 1:7310 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3165
Practice Address - Country:US
Practice Address - Phone:248-403-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020897271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical