Provider Demographics
NPI:1699113340
Name:BERRYHILL, NICOLE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ELIZABETH
Last Name:BERRYHILL
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 1:393 CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-7620
Mailing Address - Country:US
Mailing Address - Phone:304-270-6734
Mailing Address - Fax:
Practice Address - Street 1:46 TRIFECTA PL
Practice Address - Street 2:SUITE 105
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-5652
Practice Address - Country:US
Practice Address - Phone:304-725-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst