Provider Demographics
NPI:1124470422
Name:BERRICK, TAYLOR (MS, LCMHC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BERRICK
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:497 HOOKSETT RD # 322
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2698
Mailing Address - Country:US
Mailing Address - Phone:978-226-8263
Mailing Address - Fax:
Practice Address - Street 1:61 ROUTE 27 STE 10
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1273
Practice Address - Country:US
Practice Address - Phone:978-226-8263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health