Basic Information
| Provider Information | |||||||||
| NPI: | 1891916862 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | MA, LMHP, CPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2633 P ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024758717 | ||||||||
| FaxNumber: | 4024756728 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S 13TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685083533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024755161 | ||||||||
| FaxNumber: | 4024753300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 101YM0800X | 2535 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.