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Individual
DR. JODIE BERGQUIST
Active
Individual
DR. JODIE BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPC, LPC-S, LCDC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12785
TX
101YP2500X
Professional Counselor
5351
TN
101YP2500X
Professional Counselor
Primary
71819
TX
Other
Enumeration date
06/06/2016
Last updated
07/30/2026
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