MEDICARE: JANA BERGFELD MSW,LCSW

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
1	1041C0700X	Clinical Social Worker	I.1700113	OH

General Provider Information

NPI Number	:	1366573610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA BERGFELD MSW,LCSW

Provider Business Mailing Address
First Line	:	1071 FISHINGER RD
Second Line	:	STE 211
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2357
Country	:	US
Telephone Number	:	708-373-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	1071 FISHINGER RD
Second Line	:	STE 211
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2357
Country	:	US
Telephone Number	:	708-373-5959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/02/2021

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