Provider Demographics
NPI:1578580015
Name:BERKOVITZ, DAHLIA B (PHD, LMSW, LMFT)
Entity Type:Individual
Prefix:DR
First Name:DAHLIA
Middle Name:B
Last Name:BERKOVITZ
Suffix:
Gender:F
Credentials:PHD, LMSW, LMFT
Other - Prefix:
Other - First Name:DAHLIA
Other - Middle Name:B
Other - Last Name:ROSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD,LMSW,LMFT
Mailing Address - Street 1:42450 TWELVE MILE RD.
Mailing Address - Street 2:SUITE #315
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3011
Mailing Address - Country:US
Mailing Address - Phone:248-513-4100
Mailing Address - Fax:
Practice Address - Street 1:42450 TWELVE MILE RD.
Practice Address - Street 2:SUITE #315
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3013
Practice Address - Country:US
Practice Address - Phone:248-513-4100
Practice Address - Fax:248-513-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801072470104100000X
MI4101006185106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist