Provider Demographics
NPI:1114414786
Name:BERGER, ALEXANDRA (LMHC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EDSCHO LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4806
Mailing Address - Country:US
Mailing Address - Phone:631-670-6931
Mailing Address - Fax:
Practice Address - Street 1:444 COMMUNITY DR STE 304
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3820
Practice Address - Country:US
Practice Address - Phone:516-628-7497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health