Provider Demographics
NPI:1740251776
Name:BERSCH, DONNA RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:RENEE
Last Name:BERSCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 W 69TH ST
Mailing Address - Street 2:#4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5243
Mailing Address - Country:US
Mailing Address - Phone:212-496-2456
Mailing Address - Fax:
Practice Address - Street 1:18 W 69TH ST
Practice Address - Street 2:#4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5243
Practice Address - Country:US
Practice Address - Phone:212-496-2456
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039860-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical