Doctor Name: | JACOB E. BERGER |
NPI Number: | 1720317779 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.S.W. |
License Number: | 079744 |
Business Practice Address: | 4525 Henry Hudson Pkwy Apt 810 Bronx, NY - 104713811 |
Business Phone Number: | 9178853424 |
Business Fax Number: | |
Mailing Address: | 4525 Henry Hudson Pkwy Apt 810, BRONX |
State: | NY |
Postal Code: | 104713811 |
Phone Number: | 9178853424 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2009 |
NPI Last Update Date: | 01/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 079744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |