Provider Demographics
NPI:1649515669
Name:BERGER, PEARL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PEARL
Middle Name:
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 1:7 RIVERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3684
Mailing Address - Country:US
Mailing Address - Phone:203-531-1909
Mailing Address - Fax:203-532-1518
Practice Address - Street 1:7 RIVERSVILLE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3684
Practice Address - Country:US
Practice Address - Phone:203-531-1909
Practice Address - Fax:203-532-1518
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health