Healthcare Provider Details

I. General information

NPI: 1427299593
Provider Name (Legal Business Name): JUDITH G BERTSCHINGER LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11565 PEARL RD SUITE 200
STRONGSVILLE OH
44136-3356
US

IV. Provider business mailing address

12085 COUNTRY OAKS TRL
CHARDON OH
44024-9006
US

V. Phone/Fax

Practice location:
  • Phone: 440-846-0862
  • Fax: 440-846-0890
Mailing address:
  • Phone: 216-219-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE 0000920
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: