Basic Information
| Provider Information | |||||||||
| NPI: | 1417330671 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | BERGER | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | LPC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3712 MACARTHUR BLVD | ||||||||
| Address2: | STE. 209 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701146802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043525856 | ||||||||
| FaxNumber: | 5043097845 | ||||||||
| Practice Location | |||||||||
| Address1: | 3712 MACARTHUR BLVD | ||||||||
| Address2: | STE. 209 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701146802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043525856 | ||||||||
| FaxNumber: | 5043097845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2015 | ||||||||
| LastUpdateDate: | 07/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 5640 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.