Individual
MR. FREDERICK DOUGLAS BERGH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LAT
Contact information
Practice address
701 ANTLER DR STE 213, CASPER, WY 82601-1726
(720) 484-1961
Mailing address
701 ANTLER DR STE 213, CASPER, WY 82601-1726
(720) 484-1961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT-404
WY
101YM0800X
Mental Health Counselor
LPC-2038
WY
101YP2500X
Professional Counselor
Primary
LPC-2038
WY
Other
Enumeration date
08/03/2018
Last updated
08/07/2024
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