Healthcare Provider Details

I. General information

NPI: 1497260897
Provider Name (Legal Business Name): CHRISTOPHER BERGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 01/02/2025
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 MDG 300 TUSKEGEE BLVD
DOVER DE
19902-5300
US

IV. Provider business mailing address

436 MDG 300 TUSKEGEE BLVD
DOVER DE
19902
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-2674
  • Fax:
Mailing address:
  • Phone: 302-677-2674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-39691
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: