Willie Mae Berry, CMHT
Individual provider Active NPI Mental Health Counselor · Jackson, MS
NPI 1104305937 · NPPES record last updated Aug 13, 2018
Key facts
- NPI
- 1104305937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 3450 Highway 80 W
Jackson, MS 39209-7201 - Phone
- (601) 321-2400
- Fax
- (601) 985-5174
- NPI assigned
- Aug 13, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MS | Yes |
Addresses
Primary practice location
3450 Highway 80 W
Jackson, MS 39209-7201
Mailing address
3450 Highway 80 W
Jackson, MS 39209-7201
Phone (601) 321-2400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018209 | Medicaid | MS |
Other providers in Jackson, MS
- Marcus Berry
- Ray M Berry
- Regina Berry
- Teddi Leigh Berry
- Thomas Blake Berry
- Leslie Berryhill
- Anne P Berthold
- Tanika Lashun Bess
- Best Care Nursing LLC
- Best Outcomes Therapeutic Services, LLC
All providers in Jackson, MS · Mental Health Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.