Provider Demographics
NPI:1407108590
Name:BERGER, CHRISTINE (LCPC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9651 WHITEACRE RD UNIT A4
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3533
Mailing Address - Country:US
Mailing Address - Phone:410-428-0905
Mailing Address - Fax:
Practice Address - Street 1:8186 LARK BROWN RD
Practice Address - Street 2:302
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6433
Practice Address - Country:US
Practice Address - Phone:410-799-4232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional