Provider Demographics
NPI:1932504198
Name:BERGER, NICHOLAS ADAM (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:BERGER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 VALMONT RD.
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:720-449-6676
Mailing Address - Fax:303-833-4217
Practice Address - Street 1:3080 VALMONT RD.
Practice Address - Street 2:SUITE 220
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:720-449-6676
Practice Address - Fax:303-833-4217
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011628101YP2500X
COLPC0011628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional