Healthcare Provider Details

I. General information

NPI: 1184538340
Provider Name (Legal Business Name): EMILY ANNE BERGLAND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LEA AVE STE 760
NASHVILLE TN
37210-3541
US

IV. Provider business mailing address

10 LEA AVE STE 760
NASHVILLE TN
37210-3541
US

V. Phone/Fax

Practice location:
  • Phone: 201-526-8484
  • Fax: 615-610-0749
Mailing address:
  • Phone: 201-526-8484
  • Fax: 615-610-0749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: