Provider Demographics
NPI:1326794264
Name:BERGINS, ROBERTA JOY (MSW)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:JOY
Last Name:BERGINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3711
Mailing Address - Country:US
Mailing Address - Phone:914-318-2493
Mailing Address - Fax:
Practice Address - Street 1:9 OAKLEY RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-3711
Practice Address - Country:US
Practice Address - Phone:914-318-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0-25841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health