| Lisa M. Berg, Lcsw And Associates, Llc | |
|
532 Lake St Antioch IL 60002-1424 | |
| (224) 357-6793 | |
| Not Available |
| Full Name | Lisa M. Berg, Lcsw And Associates, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 532 Lake St, Antioch, Illinois |
| Authorized Official Name and Position | Lisa M Berg (OWNER/THERAPIST) |
| Authorized Official Contact | 2247888156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M. Berg, Lcsw And Associates, Llc 869 Mocking Bird Dr Antioch IL 60002-2726 Ph: (224) 788-8156 | Lisa M. Berg, Lcsw And Associates, Llc 532 Lake St Antioch IL 60002-1424 Ph: (224) 357-6793 |
| NPI Number | 1659768083 |
|---|---|
| Provider Enumeration Date | 04/23/2015 |
| Last Update Date | 04/23/2015 |
| Medicare PECOS PAC ID | 9931428562 |
|---|---|
| Medicare Enrollment ID | O20150504001789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659768083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149007142 (Illinois) | Primary |
| Provider Name | Lisa M Berg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528100484 PECOS PAC ID: 0840519476 Enrollment ID: I20150505001091 |
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