Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | PC001895 | PA |
Y | 103G00000X | Clinical Psychologist | PS016996 | PA |
Y | 103TC0700X | Clinical Psychologist | PS016996 | PA |
NPI | 1003886656 |
---|---|
Provider Name | Ms. Kathleen S. Berkey |
First Address | Meadville, PA 16335-2945 |
Second Address | Meadville, PA 16335-3757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 07/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1022563030003 | (05) | PA |