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Individual
SAMANTHA LEE BERGSTEIN
Active
Individual
SAMANTHA LEE BERGSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1700637
OH
1041C0700X
Clinical Social Worker
Primary
I.1901939
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264054
—
OH
05
—
0413879
—
OH
Enumeration date
12/18/2017
Last updated
12/21/2023
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