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NPI Code Detail

MEDICARE: KATE BERGMAN MSW

MEDICARE: KATE BERGMAN MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI-0008916OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164595344
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATE BERGMAN MSW
Provider Business Mailing Address
First Line : 24075 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5846
Country : US
Telephone Number : 216-292-3999
Fax Number : 216-292-6313
Provider Business Practice Location Address
First Line : 12200 FAIRHILL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44120-1058
Country : US
Telephone Number : 216-292-3999
Fax Number : 216-292-6313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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