Provider Demographics
NPI:1144698986
Name:BERRY, CHRISTINA LYNN (MC, LAC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LYNN
Last Name:BERRY
Suffix:
Gender:F
Credentials:MC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 LOWE AVE SE STE 5
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4252
Mailing Address - Country:US
Mailing Address - Phone:256-801-9162
Mailing Address - Fax:
Practice Address - Street 1:204 LOWE AVE SE STE 5
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4252
Practice Address - Country:US
Practice Address - Phone:256-801-9162
Practice Address - Fax:256-715-9528
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101YM0800X
CA6218171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171100000XOther Service ProvidersAcupuncturist