Provider Demographics
NPI:1205326626
Name:BERKY, JULLES (CMHC)
Entity type:Individual
Prefix:
First Name:JULLES
Middle Name:
Last Name:BERKY
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-2702
Mailing Address - Country:US
Mailing Address - Phone:801-368-8864
Mailing Address - Fax:
Practice Address - Street 1:62 E 300 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1859
Practice Address - Country:US
Practice Address - Phone:385-448-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10792600-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health