Deborah G Berry
Individual provider Active NPI Mental Health Counselor · Tyrone, NM
NPI 1578029906 · NPPES record last updated Feb 11, 2019
Key facts
- NPI
- 1578029906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CMHO148821 (NM)
- Practice address
- 131 Old Ranch Road
Tyrone, NM 88065 - Phone
- (575) 590-7752
- NPI assigned
- Feb 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMHO148821 | NM | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CMHO148821 | NM | Yes |
Addresses
Primary practice location
131 Old Ranch Road
Tyrone, NM 88065
Mailing address
PO Box 523
Tyrone, NM 88065-0523
Phone (575) 590-7752
Other providers in Tyrone, NM
All providers in Tyrone, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2019. 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.