Provider Demographics
NPI:1740308436
Name:BERCE, BRIAN WILLIAM SR (LMSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:WILLIAM
Last Name:BERCE
Suffix:SR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:BERCE
Other - Middle Name:WILLIAM
Other - Last Name:BERCE
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:LIC SOCIAL WORKER
Mailing Address - Street 1:PO BOX 1767
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-1767
Mailing Address - Country:US
Mailing Address - Phone:616-235-2090
Mailing Address - Fax:616-235-2099
Practice Address - Street 1:2828 KRAFT AVE SE
Practice Address - Street 2:STE 186
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-7700
Practice Address - Country:US
Practice Address - Phone:616-949-9550
Practice Address - Fax:616-949-9551
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010700451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical