Provider Demographics
NPI:1457424640
Name:BERMAN, BRUCE Z (MED,LMHC, LADC)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:Z
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MED,LMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WASHINGTON ST APT 305
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5869
Mailing Address - Country:US
Mailing Address - Phone:617-461-4151
Mailing Address - Fax:844-868-5052
Practice Address - Street 1:167 WASHINGTON ST STE 18A
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1797
Practice Address - Country:US
Practice Address - Phone:617-461-4151
Practice Address - Fax:844-868-5052
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA816101YA0400X
MA1811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)