Provider Demographics
NPI:1235306531
Name:BERTGES, BRIE MORGAN (QMHP, LPC, CADC)
Entity Type:Individual
Prefix:MISS
First Name:BRIE
Middle Name:MORGAN
Last Name:BERTGES
Suffix:
Gender:F
Credentials:QMHP, LPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-5410
Mailing Address - Country:US
Mailing Address - Phone:217-442-3200
Mailing Address - Fax:217-442-7460
Practice Address - Street 1:210 AVENUE C
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5410
Practice Address - Country:US
Practice Address - Phone:217-442-3200
Practice Address - Fax:217-442-7460
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178-005567101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional