Provider Demographics
NPI:1245993047
Name:BERGER, CHARLOTTE R (LMHC, LPC)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:R
Last Name:BERGER
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 POST RD E # 572
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4540
Mailing Address - Country:US
Mailing Address - Phone:203-973-7784
Mailing Address - Fax:
Practice Address - Street 1:606 POST RD E # 572
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4540
Practice Address - Country:US
Practice Address - Phone:203-973-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011224101YM0800X
CT5134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health