Kathleen Leilani Bergquist, , MSW, LCSW, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5485-C Issued in NV

Practice address

9739 Manheim LN
Las Vegas, NV 89117-6921

Phone

(702) 301-3417

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249171200000",
    "number": "1730134578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9739 MANHEIM LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891176921",
            "telephone_number": "702-301-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9739 MANHEIM LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891176921",
            "telephone_number": "702-301-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "KATHLEEN",
        "middle_name": "LEILANI",
        "name_prefix": "Dr.",
        "credential": ", MSW, LCSW, PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5485-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508688",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Jo Bergerson, MSW/LSW
• Kelsey Esther Bergey, LPMT, MMT, MT-BC
• Natalie Bergl, BSW
• Kristina L Berglund
• Caridad Bergolla Alvarez
• Thomas M Bergren, DO
• Kimberly Bergstrom
• Nurayni Berhan
• Naomi Berhane
• Bethel Berhanu

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2009; 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.