Provider Demographics
NPI:1255479648
Name:BERMAN, CARYN P (MED MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:CARYN
Middle Name:P
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MED MSW LICSW
Other - Prefix:MS
Other - First Name:CARYN
Other - Middle Name:P
Other - Last Name:BLAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED MSW LICSW
Mailing Address - Street 1:15 LUCIA RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-2018
Mailing Address - Country:US
Mailing Address - Phone:781-631-3029
Mailing Address - Fax:
Practice Address - Street 1:15 LUCIA RD
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2018
Practice Address - Country:US
Practice Address - Phone:781-631-3029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical