Individual provider Active NPI

Julie E Bergstresser, MSW, LCSW

  • Clinical Social Worker
  • Lebanon, PA
National Provider Identifier
1184876237
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017289 Issued in PA
Practice address
1700 S Lincoln Ave
595/500
Lebanon, PA 17042-7529
Phone
(717) 272-6621
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW017289 PA Primary

Addresses

Primary practice location

1700 S Lincoln Ave
595/500
Lebanon, PA 17042-7529

Mailing address

1700 S Lincoln Ave
595/500
Lebanon, PA 17042-7529
Phone (717) 272-6621

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW017289PAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1184876237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "address_2": "595/500",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "address_2": "595/500",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTRESSER",
        "first_name": "JULIE",
        "middle_name": "E",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.