Provider Demographics
NPI:1811877525
Name:BERRY, MATTHEW LUIS (LPCC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LUIS
Last Name:BERRY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HARVEY DR APT 128
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3601
Mailing Address - Country:US
Mailing Address - Phone:209-395-7716
Mailing Address - Fax:
Practice Address - Street 1:6620 VIA DEL ORO
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1452
Practice Address - Country:US
Practice Address - Phone:408-360-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health