Provider Demographics
NPI:1497575492
Name:BERING, KERRY (LCMHC-A)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BERING
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 GUM BRANCH RD STE 107
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-6270
Mailing Address - Country:US
Mailing Address - Phone:910-939-0798
Mailing Address - Fax:910-593-3510
Practice Address - Street 1:825 GUM BRANCH RD STE 107
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6270
Practice Address - Country:US
Practice Address - Phone:910-939-0798
Practice Address - Fax:910-593-3510
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health