Provider Demographics
NPI:1982842670
Name:BERGER, JAIME LEE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LEE
Last Name:BERGER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SCOTT CT
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3951
Mailing Address - Country:US
Mailing Address - Phone:319-325-0637
Mailing Address - Fax:
Practice Address - Street 1:306 SCOTT CT
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3951
Practice Address - Country:US
Practice Address - Phone:319-325-0637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0068961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical