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General NPI Number Information
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NPI Number | 1326904665
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Entity Type | Organization
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Legal Business Name | BERGIN COUNSELING AND CONSULTATION, PLLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1100 HARTFORD TPKE APT 708
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City | VERNON
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State | CT
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Zip | 06066-9411
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Country | US
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Telephone | 860-245-8698
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Fax |
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Provider Business Mailing Address
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Address Line | 35 TALCOTTVILLE RD, #1068 STE 10
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City | VERNON
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State | CT
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Zip | 06066
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Country | US
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Telephone | 860-245-8698
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COURTNEY MARIE BERGIN
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Credential | LCSW
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Telephone | 860-245-8698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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