Individual
MS. BERYL ELAINE MINKLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
20 SACRAMENTO ST, CAMBRIDGE, MA 02138-1856
(617) 661-0248
(617) 661-1923
Mailing address
20 SACRAMENTO ST, CAMBRIDGE, MA 02138-1856
(617) 661-0248
(617) 661-1923
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
102742
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011984
HARVARD PILGRIM/PBHC
MA
01
—
346214
MAGELLAN
MA
01
—
P02830
BLUECROSS/BLUESHIELD
MA
Enumeration date
10/29/2005
Last updated
07/08/2007
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