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General NPI Number Information
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NPI Number | 1013308402
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Entity Type | Individual
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Provider Name | KRISTIAN NICOLE BERGER LMHC, MA
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Gender | Female
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Dates
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Enumeration Date | 02/07/2015
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 9400 4TH ST N STE 200
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City | ST PETERSBURG
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State | FL
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Zip | 33702-2501
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Country | US
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Telephone | 727-513-2962
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Fax |
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Provider Business Mailing Address
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Address Line | 818 SOUTHWEST BLVD N
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City | ST PETERSBURG
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State | FL
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Zip | 33703-1238
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Country | US
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Telephone | 413-667-9642
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 12448
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License Number State | FL
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