Provider Demographics
NPI:1225635899
Name:BERGER, CAROLYN A (LPCC, LMHC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:A
Last Name:BERGER
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 DALE AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2473
Mailing Address - Country:US
Mailing Address - Phone:561-779-8179
Mailing Address - Fax:
Practice Address - Street 1:7831 E BUSH LAKE RD STE 200D
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55436-2303
Practice Address - Country:US
Practice Address - Phone:612-662-7407
Practice Address - Fax:612-500-4918
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10001361101YM0800X
MN2616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health