Provider Demographics
NPI:1881735678
Name:BERGGREN, SUZANNE (MSW, LSW, CCDPD)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:BERGGREN
Suffix:
Gender:F
Credentials:MSW, LSW, CCDPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E BEAU ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4702
Mailing Address - Country:US
Mailing Address - Phone:724-222-4880
Mailing Address - Fax:
Practice Address - Street 1:22 E BEAU ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4702
Practice Address - Country:US
Practice Address - Phone:724-222-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-007692-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical