Provider Demographics
NPI:1346940905
Name:DERIK S. BERKEBILE, LCSW OUTPATIENT COUNSELING SERVICES
Entity Type:Organization
Organization Name:DERIK S. BERKEBILE, LCSW OUTPATIENT COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DERIK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BERKEBILE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:814-254-4588
Mailing Address - Street 1:334 BUDFIELD ST STE 152
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3345
Mailing Address - Country:US
Mailing Address - Phone:814-254-4588
Mailing Address - Fax:814-254-4215
Practice Address - Street 1:334 BUDFIELD ST STE 152
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3345
Practice Address - Country:US
Practice Address - Phone:814-254-4588
Practice Address - Fax:814-254-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty