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General NPI Number Information
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NPI Number | 1518218627
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Entity Type | Individual
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Provider Name | KRISTINE BERSCH LSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 400D LAKE ST
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City | RAMSEY
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State | NJ
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Zip | 07446-1279
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Country | US
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Telephone | 201-835-4361
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Fax |
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Provider Business Mailing Address
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Address Line | 3910 MELVILLE CT
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City | MAHWAH
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State | NJ
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Zip | 07430-2308
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Country | US
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Telephone | 201-835-4361
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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 | 44SL05781700
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License Number State | NJ
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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 |
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License Number State |
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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 | 44SC05657100
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License Number State | NJ
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