Provider Demographics
NPI:1336671122
Name:BERMAN, ASHLEY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4418 ACACIA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3322
Mailing Address - Country:US
Mailing Address - Phone:330-714-5196
Mailing Address - Fax:
Practice Address - Street 1:4418 ACACIA DR
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3322
Practice Address - Country:US
Practice Address - Phone:330-714-5196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-17-25201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst