Patrice Berman, LICSW

Individual provider Active NPI Professional Counselor · Boston, MA

NPI 1104905421 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1104905421
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
1027205 (MA)
Practice address
7 Haviland St
Boston, MA 02115-2683
Phone
(617) 267-0900
Fax
(617) 267-3667
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1027205 MA Yes

Addresses

Primary practice location

7 Haviland St
Boston, MA 02115-2683

Mailing address

7 Haviland St
Boston, MA 02115-2683
Phone (617) 267-0900

Other identifiers

IdentifierTypeStateIssuer
1303546MedicaidMA

Other providers in Boston, MA

All providers in Boston, MA · Professional Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.