Provider Demographics
NPI:1720417181
Name:BERK, DAVID (MA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BERK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 ROHRERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2319
Mailing Address - Country:US
Mailing Address - Phone:717-509-9875
Mailing Address - Fax:717-509-9876
Practice Address - Street 1:1743 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2319
Practice Address - Country:US
Practice Address - Phone:717-509-9875
Practice Address - Fax:717-509-9876
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor