Individual
MARK BERVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, LPC
Contact information
Practice address
555 7TH ST W STE 203, SAINT PAUL, MN 55102-3068
(612) 964-1747
(612) 964-1747
Mailing address
44 ARTHUR AVE SE, MINNEAPOLIS, MN 55414-3448
(612) 964-1747
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304104
MN
101YM0800X
Mental Health Counselor
Primary
01987
MN
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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