Anita Jean Bergin, MSW
Individual provider Active NPI Clinical Social Worker · Keyport, NJ
NPI 1609808377 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1609808377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SC 000215 (NJ)
- Practice address
- 117 State Route 35
Suite 5
Keyport, NJ 07735-1406 - Phone
- (732) 264-7999
- Fax
- (732) 264-8140
- NPI assigned
- Jul 6, 2006
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC 000215 | NJ | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SC 000215 | NJ | Yes |
Addresses
Primary practice location
117 State Route 35
Suite 5
Keyport, NJ 07735-1406
Mailing address
117 State Route 35
Suite 5
Keyport, NJ 07735-1406
Phone (732) 264-7999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P2942323 | Other | NJ | OXFORD |
| 29202 | Other | NJ | CIGNA |
| 0467769000 | Other | NJ | AMERIHEALTH |
| 0080073 | Other | NJ | GHI |
| 169348 | Other | NJ | MHN/HEALTHNET |
| 270606 | Other | NJ | VALUE OPTIONS |
| 34930600 | Other | NJ | MAGELLAN BEHAVIORAL HEALT |
Other providers in Keyport, NJ
- Aisa Uguumursaikhan Almeida
- John A Barone
- Ira Brian Bauman
- Bayshore Chiropractic Center PA
- Bayshore Pain Management LLC
- Beyondcaregiver Healthcare LLC
- Block 46521 LLC
- Ted Block
- Bloombridge Psychiatry
- Tesha M Bright
All providers in Keyport, 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 Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.