David Ray Berry, MSHR/ICAADC/LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Muskogee, OK

NPI 1831280767 · NPPES record last updated Sep 19, 2007

Key facts

NPI
1831280767
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
353 (OK)
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(918) 577-3039
Fax
(918) 577-3270
NPI assigned
Sep 27, 2006
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 353 OK Yes

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

23685 S 472 Rd
Tahlequah, OK 74464-1548
Phone (918) 458-0179

Other providers in Muskogee, OK

All providers in Muskogee, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.