Provider Demographics
NPI:1285027656
Name:BERGEN, APRIL
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:BERGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 NORTHERN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3898
Mailing Address - Country:US
Mailing Address - Phone:405-202-7863
Mailing Address - Fax:405-701-0590
Practice Address - Street 1:2713 NORTHERN HILLS RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-3898
Practice Address - Country:US
Practice Address - Phone:405-202-7863
Practice Address - Fax:405-701-0590
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
OK81611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251B00000XAgenciesCase Management