Provider Demographics
NPI:1609178730
Name:LITRIN-BERGER, LAURA (CSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LITRIN-BERGER
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 WESTMINSTER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2402
Mailing Address - Country:US
Mailing Address - Phone:917-873-9493
Mailing Address - Fax:718-421-7200
Practice Address - Street 1:770 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2402
Practice Address - Country:US
Practice Address - Phone:917-873-9493
Practice Address - Fax:718-421-7200
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR014429-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0078753OtherGROUP HEALTH INSURANCE PROVIDER NUMBER