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General NPI Number Information
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NPI Number | 1265974166
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Entity Type | Individual
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Provider Name | DEBRA M. BERGMAN LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 78 MERRELL RD
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City | LEICESTER
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State | NC
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Zip | 28748-7567
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Country | US
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Telephone | 336-708-5325
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Fax |
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Provider Business Mailing Address
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Address Line | 338 BUTEO RDG
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City | PITTSBORO
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State | NC
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Zip | 27312-9327
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Country | US
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Telephone | 336-708-5325
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT000743
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1786
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License Number State | NC
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