Provider Demographics
NPI:1063749257
Name:BERENT, AMY MICHELLE (MA, LLP, LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:BERENT
Suffix:
Gender:F
Credentials:MA, LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 PATHWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8742
Mailing Address - Country:US
Mailing Address - Phone:928-925-1004
Mailing Address - Fax:
Practice Address - Street 1:3820 MERTON DR
Practice Address - Street 2:SUITE 218
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6609
Practice Address - Country:US
Practice Address - Phone:919-781-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health