Individual provider Active NPI

Caitlin Elizabeth Bergh, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1407595812
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108274 Issued in CA
Practice address
11340 W Olympic Blvd Ste 307
Los Angeles, CA 90064-1630
Phone
(310) 772-8118
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 108274 CA Primary

Addresses

Primary practice location

11340 W Olympic Blvd Ste 307
Los Angeles, CA 90064-1630

Mailing address

11340 W Olympic Blvd Ste 307
Los Angeles, CA 90064-1630
Phone (310) 772-8118

Other practice location 1

12268 Ventura Blvd Fl 2
Studio City, CA 91604-2518
Phone (310) 772-8118

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1407595812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 W OLYMPIC BLVD STE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641630",
            "telephone_number": "310-772-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 W OLYMPIC BLVD STE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641630",
            "telephone_number": "310-772-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12268 Ventura Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Studio City",
            "state": "CA",
            "postal_code": "916042518",
            "country_code": "US",
            "telephone_number": "310-772-8118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGH",
        "first_name": "CAITLIN",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.