Mary Dawn Berry, ICADAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Sioux City, IA
NPI 1649545880 · NPPES record last updated Mar 21, 2012
Key facts
- NPI
- 1649545880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 704927 (IA)
- Practice address
- 1221 Pierce St
Sioux City, IA 51105-1418 - Phone
- (712) 255-0232
- Fax
- (712) 255-0354
- NPI assigned
- Mar 21, 2012
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 704927 | IA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 704927 | IA | Yes |
Addresses
Primary practice location
1221 Pierce St
Sioux City, IA 51105-1418
Mailing address
3700 28TH St SPC 401
Sioux City, IA 51105-2300
Phone (712) 204-0014
Other providers in Sioux City, IA
- Robert J Berger
- Bradley J Bergeson
- Nadine A Bergin
- Jon Beringer
- Jacquelyn S Berke
- Anna Bertrand
- Margaret A Bessman-Quintero
- Aaron Paul Bessmer
- Joada Jean Best
- Beth Bruening PC
All providers in Sioux City, IA · Addiction (Substance Use Disorder) Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2012. 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.