Provider Demographics
NPI:1134538101
Name:MCELRATH, BERTEL JOSEPH (MA)
Entity type:Individual
Prefix:
First Name:BERTEL
Middle Name:JOSEPH
Last Name:MCELRATH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2424
Mailing Address - Country:US
Mailing Address - Phone:763-421-5535
Mailing Address - Fax:763-433-0226
Practice Address - Street 1:66 WEST ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5861
Practice Address - Country:US
Practice Address - Phone:413-343-4264
Practice Address - Fax:763-433-0226
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MNLPCC1379101YM0800X
MALMHC10002298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health