Provider Demographics
NPI:1205073509
Name:BERLINBERG, RICHARD KEVIN (MSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KEVIN
Last Name:BERLINBERG
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11410 CORAL BAY DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-1921
Mailing Address - Country:US
Mailing Address - Phone:561-445-2372
Mailing Address - Fax:561-477-3698
Practice Address - Street 1:11410 CORAL BAY DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-1921
Practice Address - Country:US
Practice Address - Phone:561-445-2372
Practice Address - Fax:561-477-3698
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010650001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical