Provider Demographics
NPI:1972652758
Name:FLEGER-BERMAN, LINDA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:FLEGER-BERMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 DEAN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-4211
Mailing Address - Country:US
Mailing Address - Phone:617-738-9480
Mailing Address - Fax:617-487-5743
Practice Address - Street 1:123 DEAN RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4211
Practice Address - Country:US
Practice Address - Phone:617-738-9480
Practice Address - Fax:617-487-5743
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01478Medicare PIN