Provider Demographics
NPI:1679334908
Name:BERGMAN COUNSELING
Entity Type:Organization
Organization Name:BERGMAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHS
Authorized Official - Phone:802-858-9369
Mailing Address - Street 1:14 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-2068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 WILLOW LN
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-2068
Practice Address - Country:US
Practice Address - Phone:802-858-9369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health