Provider Demographics
NPI:1780639641
Name:HABERMAN, BERNA G (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:BERNA
Middle Name:G
Last Name:HABERMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7938
Mailing Address - Country:US
Mailing Address - Phone:508-872-9795
Mailing Address - Fax:508-872-9795
Practice Address - Street 1:41 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7938
Practice Address - Country:US
Practice Address - Phone:508-872-9795
Practice Address - Fax:508-872-9795
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC 001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001OtherLMHC LICENSE NUMBER
MA96535OtherMHN INSURANCE
MA142OtherLMFT LICENSE NUMBER
MA0039OtherBLUE CROSS BLUE SHIELD
MA368405OtherMAGELLAN INSURANCE