Provider Demographics
NPI:1548313380
Name:BERGER, MARY E (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:BERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E JOHN CARPENTER
Mailing Address - Street 2:STE 436
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:972-506-0700
Mailing Address - Fax:972-869-4054
Practice Address - Street 1:511 E JOHN CARPENTER
Practice Address - Street 2:STE 436
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:972-506-0700
Practice Address - Fax:972-869-4054
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08565104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005814Medicare ID - Type Unspecified