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General NPI Number Information
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NPI Number | 1447527601
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Entity Type | Individual
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Provider Name | SUZANNE MICHELE BERGMANN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 2100 NESCONSET HWY # 1027
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City | STONY BROOK
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State | NY
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Zip | 11790-3503
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Country | US
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Telephone | 631-600-3407
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 NESCONSET HWY # 1067
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City | STONY BROOK
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State | NY
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Zip | 11790-3503
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Country | US
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Telephone | 631-600-3407
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 072486
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC23140
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904015217
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LICSW1120580
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06082500
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TPSW1585
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0135391TELE
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License Number State | VT
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TLS425CP
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License Number State | SC
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Taxonomy #9
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TH00946707
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License Number State | WV
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Taxonomy #10
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | Q5-0000089
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License Number State | DE
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Taxonomy #11
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082913
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License Number State | NY
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