Provider Demographics
NPI:1528855236
Name:BERRY, TONYA MARIE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:MARIE
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:DANESE
Mailing Address - State:WV
Mailing Address - Zip Code:25831-0163
Mailing Address - Country:US
Mailing Address - Phone:304-719-6062
Mailing Address - Fax:304-719-6062
Practice Address - Street 1:PO BOX 163
Practice Address - Street 2:
Practice Address - City:DANESE
Practice Address - State:WV
Practice Address - Zip Code:25831-0163
Practice Address - Country:US
Practice Address - Phone:304-719-6062
Practice Address - Fax:304-719-6062
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker