Provider Demographics
NPI:1295084754
Name:BERRYHILL, MICHAEL V (LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:V
Last Name:BERRYHILL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1998 OVERTON TRL
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-4411
Mailing Address - Country:US
Mailing Address - Phone:404-788-4138
Mailing Address - Fax:
Practice Address - Street 1:4151 MEMORIAL DR
Practice Address - Street 2:SUITE 209C
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1504
Practice Address - Country:US
Practice Address - Phone:505-508-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional