Provider Demographics
NPI:1710248075
Name:BERT, LINDA MONIQUE (MA, LMFT, CAAP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MONIQUE
Last Name:BERT
Suffix:
Gender:F
Credentials:MA, LMFT, CAAP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MONIQUE
Other - Last Name:GALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:8760 SW 21ST CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6732
Mailing Address - Country:US
Mailing Address - Phone:352-389-5417
Mailing Address - Fax:714-333-4407
Practice Address - Street 1:8760 SW 21ST CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6732
Practice Address - Country:US
Practice Address - Phone:352-389-5417
Practice Address - Fax:714-333-4407
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT96137106H00000X
FLMT3876106H00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7570OtherMEDICAID DMH
FL1710248075Medicaid
CA1710248075Medicaid
FL811706Medicaid