Individual
LESA GAIL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
206 CENTRE ON THE LK, LAKE ST LOUIS, MO 63367-1370
(636) 699-2165
(636) 625-1633
Mailing address
206 CENTRE ON THE LK, LAKE ST LOUIS, MO 63367-1370
(636) 699-2165
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2001029221
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498442706
—
MO
01
—
89520
NATIONAL BOARD FOR CERT C
—
Enumeration date
11/21/2006
Last updated
01/22/2015
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