Provider Demographics
NPI:1891843306
Name:BERGMAN, ROBERTA GELFAND (MSW,LCSWBCD)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:GELFAND
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:MSW,LCSWBCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PINE ISLAND RD
Mailing Address - Street 2:SUITE262
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2673
Mailing Address - Country:US
Mailing Address - Phone:954-452-7559
Mailing Address - Fax:954-452-7559
Practice Address - Street 1:300 S PINE ISLAND RD
Practice Address - Street 2:SUITE262
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2673
Practice Address - Country:US
Practice Address - Phone:954-452-7559
Practice Address - Fax:954-452-7559
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW15091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical