Provider Demographics
NPI:1639570260
Name:BERMAN, ESTHER NICOLE (BED, MSHS)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:NICOLE
Last Name:BERMAN
Suffix:
Gender:F
Credentials:BED, MSHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17507 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-7835
Mailing Address - Country:US
Mailing Address - Phone:276-525-6043
Mailing Address - Fax:888-233-7885
Practice Address - Street 1:17507 LEE HWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-7835
Practice Address - Country:US
Practice Address - Phone:276-525-6043
Practice Address - Fax:888-233-7885
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA134000246106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program