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General NPI Number Information
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NPI Number | 1942480504
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Entity Type | Organization
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Legal Business Name | BERGER COUNSELING AND CONSULTING SERVICES
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 697 STATE AVE
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City | BEAVER
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State | PA
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Zip | 15009-9502
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Country | US
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Telephone | 724-630-9851
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Fax |
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Provider Business Mailing Address
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Address Line | 162 GAS VALLEY RD
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City | GEORGETOWN
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State | PA
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Zip | 15043-1058
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Country | US
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Telephone | 724-630-9851
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARRY S BERGER
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Credential | LPC
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Telephone | 724-630-9851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC003529
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License Number State | PA
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