Provider Demographics
NPI:1235506114
Name:BERTI, MARIA ANDREA (MA , LSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANDREA
Last Name:BERTI
Suffix:
Gender:F
Credentials:MA , LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3421
Mailing Address - Country:US
Mailing Address - Phone:440-205-2686
Mailing Address - Fax:440-358-1930
Practice Address - Street 1:134 S.ST.CLAIR ST.,
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077
Practice Address - Country:US
Practice Address - Phone:440-205-2686
Practice Address - Fax:440-358-1930
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0023167104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker