| Julie Bergan Counseling Llc | |
|
313 S 3rd St Goshen IN 46526-3709 | |
| (574) 535-0880 | |
| Not Available |
| Full Name | Julie Bergan Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 313 S 3rd St, Goshen, Indiana |
| Authorized Official Name and Position | Julie Elizabeth Bergan (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5742695829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Julie Bergan Counseling Llc 412 Auditorium Blvd Winona Lake IN 46590-1064 Ph: (574) 269-5829 | Julie Bergan Counseling Llc 313 S 3rd St Goshen IN 46526-3709 Ph: (574) 535-0880 |
| NPI Number | 1215458138 |
|---|---|
| Provider Enumeration Date | 06/30/2017 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 4284907155 |
|---|---|
| Medicare Enrollment ID | O20170829002947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215458138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 34007808A (Indiana) | Primary |
| Provider Name | Julie Bergan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346784006 PECOS PAC ID: 3072890201 Enrollment ID: I20170426000251 |
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