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NPI Code Detail

MEDICARE: MRS. AMBER BERRIDGE LCSW

MEDICARE: MRS. AMBER BERRIDGE 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
1101Y00000XCounselor
21041C0700XClinical Social Worker149.023668

General Provider Information

NPI Number : 1972065878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMBER BERRIDGE LCSW
Provider Business Mailing Address
First Line : 735 N LINDBERG ST
Second Line :
City : GRIFFITH
State : IN
Zip : 46319-2033
Country : US
Telephone Number : 219-682-5892
Fax Number :
Provider Business Practice Location Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-728-1744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2019
Last Update Date : 09/05/2023

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Directions to “ MRS. AMBER BERRIDGE LCSW” Practice Location

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