Doctor Name: | JACQUELINE C BERRY |
NPI Number: | 1003990003 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSW |
License Number: | R027626-1 |
Business Practice Address: | 600 E Genesee St Suite 217 Syracuse, NY - 132023130 |
Business Phone Number: | 3154220300 |
Business Fax Number: | 3154798455 |
Mailing Address: | 600 E Genesee St, SYRACUSE |
State: | NY |
Postal Code: | 132023130 |
Phone Number: | 3154220300 |
Fax Number: | 3154798455 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 12/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R027626-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |