Provider Demographics
NPI:1588918411
Name:BERKLEY, SOPHIA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE
Last Name:BERKLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:MARIE
Other - Last Name:HOLLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1041 LINCOLN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487
Mailing Address - Country:US
Mailing Address - Phone:970-819-6751
Mailing Address - Fax:
Practice Address - Street 1:1041 LINCOLN AVE STE 120
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487
Practice Address - Country:US
Practice Address - Phone:970-819-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11860101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional