PRESTON EUGENE BERRY IADC & CRADC NPI 1184873804

NPI Information

NPI: 1184873804
Provider Name: PRESTON EUGENE BERRY, IADC & CRADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1523 S. FAIRMONT STREET
DAVENPORT, IA
ZIP 52802
Phone: (563) 322-2667
Get Directions

Preston Eugene Berry, IADC & CRADC is an addiction (substance use disorder) counselor in Davenport, IA. Preston Eugene Berry, IADC & CRADC NPI is 1184873804. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1523 S. FAIRMONT STREET
DAVENPORT, IA
ZIP 52802-351
Phone: (563) 322-2667
Fax: (563) 322-3671

The enumeration date for this NPI number is 9/17/2008 and was last updated on 5/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	7544	TEXAS	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	11618-1121	TEXAS	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	37377	ILLINOIS	No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	21R028	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7544	OTHER	TEXAS	TEXAS DEPARTMENT OF STATE HEALTH SERVICES
2	37377	OTHER	ILLINOIS	CRADC
3	21R028	OTHER	IOWA	IADC
4	11618-1121	OTHER	TEXAS	ICADC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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