Sara M Berg
Individual provider Active NPI Speech-Language Pathologist · Ferdinand, IN
NPI 1619124336 · NPPES record last updated Jan 5, 2017
Key facts
- NPI
- 1619124336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.009783 (IL)
- Practice address
- 768 E Mariah Hill Rd
Ferdinand, IN 47532-9737 - Phone
- (217) 497-4958
- NPI assigned
- Aug 25, 2008
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 146.009783 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.009783 | IL | Yes |
Addresses
Primary practice location
768 E Mariah Hill Rd
Ferdinand, IN 47532-9737
Mailing address
768 E Mariah Hill Rd
Ferdinand, IN 47532-9737
Phone (217) 497-4958
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37068625001 | Medicaid | IL |
Other providers in Ferdinand, IN
- 223 Ferdinand Professional, PC
- Michelle Becher
- Jane F. Becker
- Abe Michael Berg
- Alyssa Bieker
- Deaconess Clinic Inc
- Deaconess Memorial Medical Center Inc
- Nathan Randall Denning
- September Dawn Foster
All providers in Ferdinand, IN · Speech-Language Pathologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2017. 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.