Thomas Anton Bergvik, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2440 Issued in CT

Practice address

3074 Whitney Ave
Building I 2ND Floor
Hamden, CT 06518-2391

Phone

(860) 305-2764

Fax

(203) 287-2404

NPI assigned

Jan 5, 2010

Last updated

Feb 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bergvik Counseling Services, LLC

  • Professional Counselor
  • Hamden, CT
  • NPI 1720409733
  Authorized official Same address or phone

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1265762827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 WHITNEY AVE",
            "address_2": "BUILDING I 2ND FLOOR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182391",
            "telephone_number": "860-305-2764",
            "fax_number": "203-287-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 WHITNEY AVE",
            "address_2": "BUILDING I 2ND FLOOR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182391",
            "telephone_number": "860-305-2764",
            "fax_number": "203-287-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGVIK",
        "first_name": "THOMAS",
        "middle_name": "ANTON",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008049135",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin M Bemis
• Benchmark Assisted Living LLC
• Kelly Bennett
• Michael David Bergman, MD
• Bergvik Counseling Services, LLC
• Daniel Berluti, PA-C
• Edwin Bernabe, APRN
• Douglas A Berv, MD
• Best Choice Home Health Care Inc
• Best Choice Home Health Care Inc.

• Professional Counselor in Hamden, CT
• Providers in Hamden, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.