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Individual

DR. LEA BERENTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
10110 LAKE ROAD, BOTTINEAU, ND 58318
(701) 389-7963
(701) 425-0550
Mailing address
PO BOX 267, BOTTINEAU, ND 58318-0267
(701) 389-7963
(701) 425-0550

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
487
ND
103TC0700X
Clinical Psychologist
Primary
487
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1453145
ND
Enumeration date
12/16/2013
Last updated
05/01/2026
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