Provider Demographics
NPI:1396571774
Name:BERRY, BRITTANY LYSHION (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYSHION
Last Name:BERRY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 E HELMICK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3162
Mailing Address - Country:US
Mailing Address - Phone:310-438-8783
Mailing Address - Fax:
Practice Address - Street 1:1123 E HELMICK ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3162
Practice Address - Country:US
Practice Address - Phone:310-438-8783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1258831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical