Healthcare Provider Details

I. General information

NPI: 1609186287
Provider Name (Legal Business Name): BRIANA LOREN BERGER LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANA LOREN GARCIA

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 SHADE TREE PL APT J
CATONSVILLE MD
21228-1856
US

IV. Provider business mailing address

404 SHADE TREE PL APT J
CATONSVILLE MD
21228-1856
US

V. Phone/Fax

Practice location:
  • Phone: 909-720-1959
  • Fax:
Mailing address:
  • Phone: 909-720-1959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19958
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: