Provider Demographics
NPI:1871237479
Name:OCCUPATIONAL STRESS MANAGEMENT, LLC
Entity Type:Organization
Organization Name:OCCUPATIONAL STRESS MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-388-5143
Mailing Address - Street 1:3386 S HAZEL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-9194
Mailing Address - Country:US
Mailing Address - Phone:801-388-5143
Mailing Address - Fax:
Practice Address - Street 1:5742 ADAMS AVE PKWY
Practice Address - Street 2:
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-7157
Practice Address - Country:US
Practice Address - Phone:801-388-5143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty