Provider Demographics
NPI:1750716015
Name:BERTA, ERIC TODD (LPC, NCC, CCH)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:TODD
Last Name:BERTA
Suffix:
Gender:M
Credentials:LPC, NCC, CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 27TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-4767
Mailing Address - Country:US
Mailing Address - Phone:802-324-5253
Mailing Address - Fax:
Practice Address - Street 1:239 4TH AVE STE 1618
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1758
Practice Address - Country:US
Practice Address - Phone:802-324-5253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional