Provider Demographics
NPI:1235680067
Name:BERK, BLAIR A (LPC)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:A
Last Name:BERK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BLAIR
Other - Middle Name:A
Other - Last Name:KIRSHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2370 YORK RD STE D4
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1031
Mailing Address - Country:US
Mailing Address - Phone:215-491-9900
Mailing Address - Fax:215-491-9902
Practice Address - Street 1:2370 YORK RD
Practice Address - Street 2:SUITE D-4
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929
Practice Address - Country:US
Practice Address - Phone:215-491-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional