Provider Demographics
NPI:1629431507
Name:BERGER, PATRICIA LYNN (MED, LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:BERGER
Suffix:
Gender:F
Credentials:MED, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 ROCKSIDE WOODS BLVD N STE 305
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2343
Mailing Address - Country:US
Mailing Address - Phone:216-525-1885
Mailing Address - Fax:216-525-1894
Practice Address - Street 1:6200 ROCKSIDE WOODS BLVD. SUITE 305
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131
Practice Address - Country:US
Practice Address - Phone:216-525-1885
Practice Address - Fax:216-525-1894
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional