Provider Demographics
NPI:1457065146
Name:BERKE, KRISTIN ANNE (LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANNE
Last Name:BERKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1800
Mailing Address - Country:US
Mailing Address - Phone:757-409-5283
Mailing Address - Fax:
Practice Address - Street 1:30 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-6069
Practice Address - Country:US
Practice Address - Phone:540-779-7516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional