Provider Demographics
NPI:1295245140
Name:BERKEL, SHIRLENE V (MSW, LCSW INTERN)
Entity type:Individual
Prefix:
First Name:SHIRLENE
Middle Name:V
Last Name:BERKEL
Suffix:
Gender:F
Credentials:MSW, LCSW INTERN
Other - Prefix:
Other - First Name:SEEKING THERAPY AND
Other - Middle Name:REACHING FOR SUCCESS
Other - Last Name:COUNSELING SERVICES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6482
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33807-6482
Mailing Address - Country:US
Mailing Address - Phone:863-500-2480
Mailing Address - Fax:
Practice Address - Street 1:5475 WILMINGTON CIR APT 209
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2764
Practice Address - Country:US
Practice Address - Phone:863-808-6862
Practice Address - Fax:863-808-6862
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW120711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical