Provider Demographics
NPI:1841826559
Name:BERRY, SUMMER D (LPC)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:D
Last Name:BERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4585 E SPEEDWAY BLVD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5309
Mailing Address - Country:US
Mailing Address - Phone:520-327-4505
Mailing Address - Fax:
Practice Address - Street 1:5934 E GRAYHAWK RANCH RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-8501
Practice Address - Country:US
Practice Address - Phone:520-559-5684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-14
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-19871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional