Provider Demographics
NPI:1538128673
Name:BERKOWITZ, REBEKAH LOUISE (MSW)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:LOUISE
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4177 D CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1071
Mailing Address - Country:US
Mailing Address - Phone:314-845-0673
Mailing Address - Fax:
Practice Address - Street 1:4177 D CRESCENT
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1071
Practice Address - Country:US
Practice Address - Phone:314-845-0673
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0000541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R01003Medicare UPIN