Julie Bergan, MSW LCSW
Individual provider Active NPI Clinical Social Worker · Goshen, IN
NPI 1346784006 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1346784006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34007808A (IN)
- Practice address
- 313 S 3Rd St
Goshen, IN 46526-3709 - Phone
- (574) 535-0880
- NPI assigned
- Dec 14, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Indiana Medical College, School of Medicine of Purdue University, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
313 S 3Rd St
Goshen, IN 46526-3709
Phone (574) 535-0880
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426000251 | IN | Practitioner - Clinical Social Worker | 3072890201 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33007154A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Julie Bergan Counseling LLC | Current |
Accepting new patients | |
| McArthur Mental Health Services | Past |
Accepting new patients |
Locations
313 S 3rd St
Goshen, IN 46526
Phone (574) 535-0880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 33007154A | IN | |
| Clinical Social Worker | 1041C0700X | 34007808A | IN | Yes |
Addresses
Primary practice location
313 S 3Rd St
Goshen, IN 46526-3709
Mailing address
2570 E Ontario LN
Warsaw, IN 46582-8200
Phone (574) 269-5829
Other providers in Goshen, IN
- Chloe Bell
- Danae Eileen Bell
- Greggory A Bell
- Justine Bender
- Marie Bennion
- James A Berndt
- Christine A Bernier
- Michael Bessesen
- Erika Bethel
- Padmanabha Rao Betina
All providers in Goshen, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.