Individual
LAWRENCE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCMHC
Contact information
Practice address
154 DUCHESS AVE, NEWPORT, VT 05855-5516
(802) 334-6744
Mailing address
154 DUCHESS AVE, NEWPORT, VT 05855-5516
(802) 334-6744
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
068-000390
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00038296
BCBS
VT
05
—
1007040
—
VT
01
—
2019225
CIGNA
VT
01
—
63V025
MVP
VT
Enumeration date
10/13/2006
Last updated
01/20/2009
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