Doctor Name: | PATRICIA S. BERGSTROM |
NPI Number: | 1477795292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LC5701 |
Business Practice Address: | 57 Water Street Blue Hill, ME - 04614 |
Business Phone Number: | 2073742311 |
Business Fax Number: | 2073743991 |
Mailing Address: | 57 Water Street, BLUE HILL |
State: | ME |
Postal Code: | 04614 |
Phone Number: | 2073742311 |
Fax Number: | 2073743991 |
NPI Enumeration Date: | 03/25/2009 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC5701 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |