Provider Demographics
NPI:1164576625
Name:BERGMAN, CATHERINE JOAN (CERTIFIED SOCIAL WOR)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JOAN
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:CERTIFIED SOCIAL WOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 FIRST AVENUE
Mailing Address - Street 2:APT 10G
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2605
Mailing Address - Country:US
Mailing Address - Phone:212-260-5997
Mailing Address - Fax:212-260-5997
Practice Address - Street 1:240 FIRST AVENUE
Practice Address - Street 2:APT 10G
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10009-2605
Practice Address - Country:US
Practice Address - Phone:212-260-5997
Practice Address - Fax:212-260-5997
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY362191041C0700X
NJ44SW001180001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical