Individual
HAVA BERGDOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
945 E HAVERFORD RD, SUITE 202 A, BRYN MAWR, PA 19010-3814
(610) 551-2534
Mailing address
856 AGNES AVE, MORTON, PA 19070-1818
(610) 551-2534
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013104
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2321091000
IBC
PA
01
—
7404316
AETNA
PA
Enumeration date
09/03/2006
Last updated
12/14/2014
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