Stephanie Bergman, MA, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014265 Issued in MI

Practice address

648 Monroe Ave NW
Grand Rapids, MI 49503

Phone

(616) 901-1429

NPI assigned

Jul 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thethirdchair

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1376820860
  NPD (past)

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1871900456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 MONROE AVE NW STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495036714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-901-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "MA, LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony J Bergman
• Kristin Jayne Bergman, RD, CSP
• Margaret A Bergman
• Paige Bergman
• Sarah Ryann Bergman
• Daniel William Bergner, M.D.
• Corwyn B Bergsma, D.P.M.
• David Willard Bergsma, M.A.
• Matt Bergsma
• Abeba M Berhane, MD

• All providers in Grand Rapids, MI
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.