# LINDSAY RAY BERGMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710197173
- **Gender:** F
- **Credential:** LISW-S, LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 1041C0700X | Clinical Social Worker | C6874 | MS | — |
| 1041C0700X | Clinical Social Worker | I1450832SUPV | OH | Yes |

## Other

- **Enumeration date:** 05/23/2007
- **Last updated:** 10/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0173042 | — | OH |