Provider Demographics
NPI:1023246709
Name:BERGER-SEMKO, AMANDA LEIGH (MS, LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEIGH
Last Name:BERGER-SEMKO
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 HIGHWAY 34
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1442
Mailing Address - Country:US
Mailing Address - Phone:732-223-9355
Mailing Address - Fax:732-223-9350
Practice Address - Street 1:2329 HIGHWAY 34
Practice Address - Street 2:SUITE 101
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1442
Practice Address - Country:US
Practice Address - Phone:732-223-9355
Practice Address - Fax:732-223-9350
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00386400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00386400OtherLICEENSED PROFESSIONAL COUNSELOR