Katharine Mary Bergacs, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Flemington, NJ
NPI 1245407162 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1245407162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC05470500 (NJ)
- Practice address
- 84 Park Ave Ste E114
Flemington, NJ 08822-1176 - Phone
- (908) 751-1208
- Fax
- (908) 824-2369
- NPI assigned
- May 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 23, 2021 through Mar 23, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05470500 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Place for Peace, LLC | Current |
Accepting new patients |
Locations
87 Park Ave
Flemington, NJ 08822
Phone (908) 751-1208
84 Park Ave
Ste E114
Flemington, NJ 08822
Phone (908) 751-1208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05470500 | NJ | Yes |
Addresses
Primary practice location
84 Park Ave Ste E114
Flemington, NJ 08822-1176
Mailing address
84 Park Ave Ste E114
Flemington, NJ 08822-1176
Phone (908) 751-1208
Other practice location 1
135 Main St
Flemington, NJ 08822-1493
Phone (908) 310-8101
Other providers in Flemington, NJ
- Erika Paige Bellomo
- Robert A Benigno
- Guy Mitchell Bennett
- Jay Robert Benson
- William Earl Bentley IV
- Tamara Joy Berisha
- Marie G Bernard
- Shirley Bershad
- Samantha Bertelson
- Ashley Berth
All providers in Flemington, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.