Provider Demographics
NPI:1003085333
Name:BERZINSKI, CARMEN C (LICSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:C
Last Name:BERZINSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MARKET ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-5532
Mailing Address - Country:US
Mailing Address - Phone:507-452-5033
Mailing Address - Fax:507-452-5183
Practice Address - Street 1:111 MARKET ST STE 4A
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-5532
Practice Address - Country:US
Practice Address - Phone:507-452-5033
Practice Address - Fax:507-452-5183
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15493101Y00000X, 101YA0400X
MN302724101YA0400X
WI15397-132101YA0400X
MN223821041C0700X
WI8362-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)