Individual provider Active NPI

Sheryl Ann Coryell, LMFT

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1962618280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35535 Issued in CA
Practice address
1903 Berkeley Way Ste 2
Berkeley, CA 94704-1007
Phone
(510) 918-2100
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35535 CA Primary

Addresses

Primary practice location

1903 Berkeley Way Ste 2
Berkeley, CA 94704-1007

Mailing address

1903 Berkeley Way Ste 2
Berkeley, CA 94704-1007
Phone (510) 918-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 12, 2024 through Feb 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35535CAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962618280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 BERKELEY WAY STE 2",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041007",
            "telephone_number": "510-918-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 BERKELEY WAY STE 2",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041007",
            "telephone_number": "510-918-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORYELL",
        "first_name": "SHERYL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "35535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.