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NPI Code Detail

MEDICARE: MRS. SANDRA R BERGER LMHC

MEDICARE: MRS. SANDRA R BERGER LMHC
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
1101YM0800XMental Health Counselor278MA

General Provider Information

NPI Number : 1972688323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA R BERGER LMHC
Provider Business Mailing Address
First Line : 24 MILLFARM RD
Second Line :
City : STOUGHTON
State : MA
Zip : 02072-1362
Country : US
Telephone Number : 781-344-9322
Fax Number :
Provider Business Practice Location Address
First Line : 190 LENOX ST
Second Line :
City : NORWOOD
State : MA
Zip : 02062-3416
Country : US
Telephone Number : 781-769-8670
Fax Number : 781-769-6717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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