Individual
CHARLES WARREN BERGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Mailing address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/02/2013
Last updated
08/26/2020
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