Provider Demographics
NPI:1073809034
Name:BERCE, HEATHER A (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:BERCE
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:DIONNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 ACADEMY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3183
Mailing Address - Country:US
Mailing Address - Phone:207-554-2352
Mailing Address - Fax:207-554-2351
Practice Address - Street 1:88 FOX ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MADAWASKA
Practice Address - State:ME
Practice Address - Zip Code:04756
Practice Address - Country:US
Practice Address - Phone:207-728-6341
Practice Address - Fax:207-728-7762
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC169561041C0700X
MECAC5411101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000Medicaid