Organization
BERGAN COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE BERGAN (OWNER)
(765) 283-5727
Entity
Organization
Contact information
Practice address
1945 W ROYALE DR, MUNCIE, IN 47304-2265
(765) 283-5727
Mailing address
3300 W RIVERSIDE AVE, NONE, MUNCIE, IN 47304-3861
(765) 283-5727
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007061A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922403807
INDIVIDUAL NPI
—
Enumeration date
01/31/2015
Last updated
01/31/2015
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