Provider Demographics
NPI:1922558980
Name:BERKSTEINER, DOROTHY (LPC)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:BERKSTEINER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:
Other - Last Name:BERKSTEINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:121 PATRICIA LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1792 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-4114
Practice Address - Country:US
Practice Address - Phone:770-960-2058
Practice Address - Fax:770-960-2024
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007611101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)