Provider Demographics
NPI:1700492998
Name:BERLIN, ANNETTE (MHC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:BERLIN
Suffix:
Gender:F
Credentials:MHC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 E FRONT ST APT 5
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3132
Mailing Address - Country:US
Mailing Address - Phone:206-259-0146
Mailing Address - Fax:
Practice Address - Street 1:435 W BELL ST STE B
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-2916
Practice Address - Country:US
Practice Address - Phone:360-207-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling