Provider Demographics
NPI:1184206443
Name:BERHALTER, DENNIS ROBERT (LMSW)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:ROBERT
Last Name:BERHALTER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST STE 1416
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-1114
Mailing Address - Country:US
Mailing Address - Phone:718-232-8600
Mailing Address - Fax:718-228-9314
Practice Address - Street 1:26 COURT ST STE 1416
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1114
Practice Address - Country:US
Practice Address - Phone:718-232-8600
Practice Address - Fax:718-228-9314
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107892-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty