Individual
PATRICIA S. BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
57 WATER STREET, BLUE HILL, ME 04614
(207) 374-2311
(207) 374-3991
Mailing address
57 WATER STREET, BLUE HILL, ME 04614
(207) 374-2311
(207) 374-3991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC1463
ME
1041C0700X
Clinical Social Worker
Primary
LC5701
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477795292
—
ME
Enumeration date
03/25/2009
Last updated
01/20/2021
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