Provider Demographics
NPI:1134994296
Name:NIVA BERMAN LCSW A LICENSED CLINICAL SOCIAL WORKER INC
Entity type:Organization
Organization Name:NIVA BERMAN LCSW A LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-677-1431
Mailing Address - Street 1:5325 ALTON PKWY STE C-343
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8610
Mailing Address - Country:US
Mailing Address - Phone:949-648-2551
Mailing Address - Fax:
Practice Address - Street 1:4000 BIRCH ST STE 203
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2258
Practice Address - Country:US
Practice Address - Phone:949-677-1431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty