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NPI Code Detail

MEDICARE: MR. ALEXANDER STEPHEN BERK JD, M.ED., LPC

MEDICARE: MR. ALEXANDER STEPHEN BERK JD, M.ED., LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor62633TX

General Provider Information

NPI Number : 1598009235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALEXANDER STEPHEN BERK JD, M.ED., LPC
Provider Business Mailing Address
First Line : 15851 DALLAS PKWY
Second Line : SUITE 600
City : ADDISON
State : TX
Zip : 75001-6030
Country : US
Telephone Number : 972-742-2000
Fax Number :
Provider Business Practice Location Address
First Line : 15851 DALLAS PKWY
Second Line : SUITE 600
City : ADDISON
State : TX
Zip : 75001-6030
Country : US
Telephone Number : 972-742-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2012
Last Update Date : 11/19/2012

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