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General NPI Number Information
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NPI Number | 1952737868
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Entity Type | Organization
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Legal Business Name | KATE BERGMAN LLC
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 6200 SOM CENTER RD SUITE D20
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City | SOLON
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State | OH
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Zip | 44139-2944
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Country | US
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Telephone | 440-836-3195
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Fax | 440-248-5599
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Provider Business Mailing Address
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Address Line | 6200 SOM CENTER RD SUITE D20
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City | SOLON
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State | OH
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Zip | 44139-2944
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Country | US
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Telephone | 440-836-3195
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Fax | 440-248-5599
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Authorized Official
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Title or Position | CEO
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Name | KATE BERGMAN
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Credential | MASW
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Telephone | 440-836-3195
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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 | I0008916
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License Number State | OH
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