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Individual

MS. SANDRA STACKS BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.A.S.A.C.

Contact information

Practice address
500 8TH AVE, 3RD FLOOR, NEW YORK, NY 10018-6504
(212) 904-1500
Mailing address
150 E 72ND ST, APT. 3S, NEW YORK, NY 10021-4365
(212) 904-1500

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1068
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20521
NY

Other

Enumeration date
05/17/2007
Last updated
07/08/2007
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