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General NPI Number Information
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NPI Number | 1255784922
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Entity Type | Individual
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Provider Name | TERISA MARIA BERGER LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 8706 SUNRISE CANTER DR
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City | TOMBALL
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State | TX
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Zip | 77375-1011
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Country | US
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Telephone | 909-838-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 21ST AVE S STE C400
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City | NASHVILLE
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State | TN
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Zip | 37212-4350
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 106212
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License Number State | CA
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