Healthcare Provider Details

I. General information

NPI: 1013196153
Provider Name (Legal Business Name): DENNIS A BERGER MA, LLP, LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 S ROCHESTER RD # 1400
ROCHESTER HILLS MI
48307-5160
US

IV. Provider business mailing address

28000 DEQUINDRE RD
WARREN MI
48092-2468
US

V. Phone/Fax

Practice location:
  • Phone: 248-844-6234
  • Fax: 248-844-6237
Mailing address:
  • Phone: 586-753-0405
  • Fax: 586-753-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301003837
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801063189
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: