| Jberry, Lpc, Llc | |
|
971 Lakeland Dr Ste 1159 Jackson MS 39216-4609 | |
| (601) 982-1010 | |
| (601) 366-0436 |
| Full Name | Jberry, Lpc, Llc |
|---|---|
| Speciality | Counselor |
| Location | 971 Lakeland Dr Ste 1159, Jackson, Mississippi |
| Authorized Official Name and Position | Jonny Berry (OWNER) |
| Authorized Official Contact | 6014219297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jberry, Lpc, Llc 971 Lakeland Dr Ste 1159 Jackson MS 39216-4609 Ph: (601) 982-1010 | Jberry, Lpc, Llc 971 Lakeland Dr Ste 1159 Jackson MS 39216-4609 Ph: (601) 982-1010 |
| NPI Number | 1821868159 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 9133572233 |
|---|---|
| Medicare Enrollment ID | O20240125000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821868159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Jonny Berry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124724539 PECOS PAC ID: 4183074982 Enrollment ID: I20231220000051 |
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