William Bergmann
Individual provider Active NPI Counselor · Willimantic, CT
NPI 1003469990 · NPPES record last updated Jul 19, 2019
Key facts
- NPI
- 1003469990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1491 Main St
Willimantic, CT 06226-1914 - Phone
- (860) 456-3215
- NPI assigned
- Jul 19, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1491 Main St
Willimantic, CT 06226-1914
Mailing address
2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 697-3351
Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.