Provider Demographics
NPI:1427402148
Name:BERKEBILE, DERIK STEVEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DERIK
Middle Name:STEVEN
Last Name:BERKEBILE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0190241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical