Organization
DR. MARY BERGE AND ASSOCIATES, LLC
Active
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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