Provider Demographics
NPI:1417330671
Name:BERGER, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3712 MACARTHUR BLVD
Mailing Address - Street 2:STE. 209
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6802
Mailing Address - Country:US
Mailing Address - Phone:504-352-5856
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:3712 MACARTHUR BLVD
Practice Address - Street 2:STE. 209
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6802
Practice Address - Country:US
Practice Address - Phone:504-352-5856
Practice Address - Fax:504-309-7845
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional