Provider Demographics
NPI:1982695995
Name:BERMAN, ROBIN (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5116 GRANDE DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3308
Mailing Address - Country:US
Mailing Address - Phone:505-480-5414
Mailing Address - Fax:505-321-1268
Practice Address - Street 1:5116 GRANDE DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3308
Practice Address - Country:US
Practice Address - Phone:505-480-5414
Practice Address - Fax:505-341-1268
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36741106H00000X
NM0070651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist