Debra M. Bergman, LMFT

Individual provider Active NPI Marriage & Family Therapist · Leicester, NC

NPI 1265974166 · NPPES record last updated Jan 24, 2022

Key facts

NPI
1265974166
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1786 (NC)
Practice address
78 Merrell Rd
Leicester, NC 28748-7567
Phone
(336) 708-5325
NPI assigned
Nov 8, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFT000743GAMDMarriage & Family Therapist
1786NCMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT000743 GA
Marriage & Family Therapist 106H00000X 1786 NC Yes

Addresses

Primary practice location

78 Merrell Rd
Leicester, NC 28748-7567

Mailing address

338 Buteo RDG
Pittsboro, NC 27312-9327
Phone (336) 708-5325

Other providers in Leicester, NC

All providers in Leicester, NC · Marriage & Family Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.