Provider Demographics
NPI:1164573648
Name:FOX-BERMAN, KRISTY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:
Last Name:FOX-BERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 OTTO RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4037
Mailing Address - Country:US
Mailing Address - Phone:908-625-7090
Mailing Address - Fax:
Practice Address - Street 1:1000 HERRONTOWN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7716
Practice Address - Country:US
Practice Address - Phone:908-625-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052719001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical