NPIMap

Organization Active NPI

Bergvik Counseling Services, LLC

  • Professional Counselor
  • Hamden, CT
National Provider Identifier
1720409733
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2440 Issued in CT
Legal business name
BERGVIK COUNSELING SERVICES, LLC
Practice address
3074 Whitney Ave
Building 1-2ND Floor
Hamden, CT 06518-2391
Phone
(860) 305-2764
Fax
(203) 287-2404
NPI assigned
Dec 17, 2013
Last updated
Dec 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Mr. Thomas Anton Bergvik, LPCNPI 1265762827
Title
Licensed Professional Counselor
Phone
(860) 305-2764

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2440 CT Primary

Addresses

Primary practice location

3074 Whitney Ave
Building 1-2ND Floor
Hamden, CT 06518-2391

Mailing address

3074 Whitney Ave
Building 1-2ND Floor
Hamden, CT 06518-2391
Phone (860) 305-2764

National Provider Directory

National Provider Directory

Locations

3074 Whitney Ave
Bldg 12ND
Hamden, CT 06518
Phone (860) 305-2764

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1720409733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 WHITNEY AVE",
            "address_2": "BUILDING 1-2ND FLOOR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182391",
            "telephone_number": "860-305-2764",
            "fax_number": "203-287-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 WHITNEY AVE",
            "address_2": "BUILDING 1-2ND FLOOR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182391",
            "telephone_number": "860-305-2764",
            "fax_number": "203-287-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGVIK COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "BERGVIK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ANTON",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "860-305-2764",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.