Provider Demographics
NPI:1235372590
Name:BERGHOFF, SHERENE ALETTA (NCC, LPC)
Entity Type:Individual
Prefix:MISS
First Name:SHERENE
Middle Name:ALETTA
Last Name:BERGHOFF
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E 760 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5479
Mailing Address - Country:US
Mailing Address - Phone:801-921-9232
Mailing Address - Fax:801-765-0088
Practice Address - Street 1:1015 E 760 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-5479
Practice Address - Country:US
Practice Address - Phone:801-921-9232
Practice Address - Fax:801-765-0088
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4949223-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health