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General NPI Number Information
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NPI Number | 1649682451
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Entity Type | Organization
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Legal Business Name | GINNY BERG, LCSW, INC.
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 800 E BROWARD BLVD SUITE 302
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2008
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Country | US
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Telephone | 954-767-8263
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Fax | 954-467-1417
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Provider Business Mailing Address
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Address Line | 800 E BROWARD BLVD SUITE 302
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2008
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Country | US
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Telephone | 954-767-8263
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Fax | 954-467-1417
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GINNY BERG
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Credential | LCSW
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Telephone | 954-767-8263
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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 | SW3874
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License Number State | FL
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