MEDICARE: NATALIE BERLIN LPC

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	101YP2500X	Professional Counselor	4825	LA

General Provider Information

NPI Number	:	1679001309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE BERLIN LPC

Provider Business Mailing Address
First Line	:	10138 CARLSBAD DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71115-3427
Country	:	US
Telephone Number	:	318-393-9810
Fax Number	:

Provider Business Practice Location Address
First Line	:	8504 LINE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-6146
Country	:	US
Telephone Number	:	318-868-2001
Fax Number	:	318-675-1517

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

Provider Enumeration Date	:	05/25/2017
Last Update Date	:	05/25/2017

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Directions to “ NATALIE BERLIN LPC” Practice Location

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