Julie Bergan Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

34007808A Issued in IN

Legal business name

JULIE BERGAN COUNSELING LLC

Practice address

313 S 3Rd St
Goshen, IN 46526-3709

Phone

(574) 535-0880

NPI assigned

Jun 30, 2017

Last updated

Oct 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Elizabeth Bergan, MSW, LCSWNPI 1346784006

Title

Clinical Social Worker

Phone

(574) 269-5829

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Bergan, MSW LCSW

  • Clinical Social Worker
  • Goshen, IN
  • NPI 1346784006
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1215458138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 AUDITORIUM BLVD",
            "city": "WINONA LAKE",
            "state": "IN",
            "postal_code": "465901064",
            "telephone_number": "574-269-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263709",
            "telephone_number": "574-535-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE BERGAN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "BERGAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "574-269-5829",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "34007808A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Jones
• Joseph Locke Counseling Services
• Talhia Yajaira Juarez Aguilar, NP
• Samuel Thomas Judd, DDS
• Lori Christine Judson
• Oksana P Jumanov
• Marvone Justice
• Amber Kaehr, RDN
• Kim W Kahler, APRN
• Andrew Kalin, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Goshen, IN
• Providers in Goshen, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.