Organization
DR. MARY BERGE AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAR BERGE (OFFICE MANAGER)
(814) 535-8586
Entity
Organization
Contact information
Practice address
1765 GOUCHER ST, STE 150, JOHNSTOWN, PA 15905-1101
(814) 535-8586
(814) 254-4170
Mailing address
1765 GOUCHER ST, STE 150, JOHNSTOWN, PA 15905-1101
(814) 535-8586
(814) 254-4170
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
168974
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019357340006P
CBHNP
PA
01
—
1483294
BCBS
—
01
—
562719
VALUE BEHAVIORAL HEALTH
PA
Enumeration date
01/13/2012
Last updated
04/30/2017
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