Provider Demographics
NPI:1609186287
Name:BERGER, BRIANA LOREN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:LOREN
Last Name:BERGER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:LOREN
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 SHADE TREE PL
Mailing Address - Street 2:APT J
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1856
Mailing Address - Country:US
Mailing Address - Phone:909-720-1959
Mailing Address - Fax:
Practice Address - Street 1:404 SHADE TREE PL
Practice Address - Street 2:APT J
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1856
Practice Address - Country:US
Practice Address - Phone:909-720-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
MD199581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner