Provider Demographics
NPI:1801687389
Name:BERKOBEN, EMILY RAE (MA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RAE
Last Name:BERKOBEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RAE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9855 RINAMAN RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9855 RINAMAN RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9226
Practice Address - Country:US
Practice Address - Phone:724-799-8558
Practice Address - Fax:412-430-3383
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health