Berry, Lisa L

Berry, Lisa L is an individual health care provider with primary practice located at 114 Grand Ave , Wausau WI 54403-6214. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Berry, Lisa L can be contacted via phone (715) 845-7175.

Contact Information

Primary practice address
114 Grand Ave Wausau WI 54403-6214
Phone: (715) 845-7175
Fax: (715) 845-7142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3131-125 Wisconsin

Profile Details

NPI number 1710006523
LBN Legal business name Berry, Lisa L
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710006523 NPPES
Wisconsin MEDICAID 40621900

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