Provider Demographics
NPI:1689850976
Name:BERRY, TAM'MEKA (LPC-SAS)
Entity type:Individual
Prefix:DR
First Name:TAM'MEKA
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:LPC-SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W SAINT PAUL AVE UNIT 197
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-2211
Mailing Address - Country:US
Mailing Address - Phone:414-368-0256
Mailing Address - Fax:414-413-4542
Practice Address - Street 1:345 W SAINT PAUL AVE UNIT 197
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-2211
Practice Address - Country:US
Practice Address - Phone:414-368-0256
Practice Address - Fax:414-413-4542
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8-226101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43739300Medicaid
WI1689850976Medicaid