Provider Demographics
NPI:1922848779
Name:BERKNER, SIERRA LOGAN (LAMFT)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:LOGAN
Last Name:BERKNER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CAMELOT RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-3860
Mailing Address - Country:US
Mailing Address - Phone:478-663-8840
Mailing Address - Fax:
Practice Address - Street 1:104 BORDERS WAY
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8966
Practice Address - Country:US
Practice Address - Phone:478-333-2182
Practice Address - Fax:888-813-6815
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist