Provider Demographics
NPI:1467843680
Name:BERG, STEPHANIE (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BERG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:SHETLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:437 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2329
Mailing Address - Country:US
Mailing Address - Phone:412-221-3302
Mailing Address - Fax:412-774-1576
Practice Address - Street 1:437 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2329
Practice Address - Country:US
Practice Address - Phone:412-221-3302
Practice Address - Fax:412-774-1576
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 006832101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional