Individual
MIRANDA ANN BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, CADC
Contact information
Practice address
3309 DIXIE HWY, ERLANGER, KY 41018-4047
(859) 609-3893
Mailing address
3149 MEADOWAY CT, INDEPENDENCE, KY 41051-6717
(859) 609-3893
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
170788
KY
101YM0800X
Mental Health Counselor
70028929
WA
101YP2500X
Professional Counselor
Primary
161536
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100337850
—
KY
Enumeration date
03/20/2014
Last updated
04/05/2026
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