Provider Demographics
NPI:1255960993
Name:BERLIN, MARCIA
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:BERLIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 8TH AVE S APT 311
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2454
Mailing Address - Country:US
Mailing Address - Phone:770-634-0202
Mailing Address - Fax:
Practice Address - Street 1:2004 HAYES ST STE 800
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2659
Practice Address - Country:US
Practice Address - Phone:615-514-6876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-04
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4222133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management