Individual
MS. CAROLYN KAY BERG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
603 BRUCE ST, CROOKSTON, MN 56716
(218) 281-3940
(218) 281-6261
Mailing address
PO BOX 603, 603 BRUCE ST, CROOKSTON, MN 56716-0603
(218) 281-3940
(218) 281-6261
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09788
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135009
UCARE MINNESOTA
MN
01
—
279T7BE
BCBS BHST
MN
01
—
6241814
UBH MEDICA
—
Enumeration date
03/18/2006
Last updated
07/08/2007
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