Bonnie Jan Berg is a Clinical in Portland, Oregon. Bonnie Jan Berg practices all healthcare services and medical treatments related to Clinical. The NPI Number for Bonnie Jan Berg is 1366518813. The last update date is 2008-05-08.
Bonnie Jan Berg's current location address is 1020 Sw Taylor St, Portland, Oregon. You can contact this provider via phone number 5032244654. The mailing address for Bonnie Jan Berg is 1020 Sw Taylor St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bonnie Jan Berg |
|---|---|
| Address | 1020 Sw Taylor St, Portland, Oregon |
| Phone Number | 5032244654 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1366518813 |
|---|---|
| Provider Enumeration Date | 2006-11-27 |
| Last Updated Date | 2008-05-08 |
Provider Mailing Address Detail
| Address | 1020 Sw Taylor St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972052543 |
| Phone Number | 5032244654 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 4065 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identifier code issued to Bonnie Jan Berg by the Centers for Medicare & Medicaid Services?
The Bonnie Jan Berg has been assigned the NPI (National Provider Identifier) 1366518813 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Bonnie Jan Berg's facilities are situated?
The facilities of Bonnie Jan Berg are physically located at the following address: 1020 Sw Taylor St, Portland, OR, 972052543.
What is Bonnie Jan Berg's specialized field of practice, and what is the corresponding taxonomy classification code?
The Bonnie Jan Berg's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did the Bonnie Jan Berg receive the assignment of its 1366518813 from the Centers for Medicare & Medicaid Services?
The Bonnie Jan Berg was issued its 1366518813 by the Centers for Medicare & Medicaid Services on 2006-11-27.
As of what date were the Bonnie Jan Berg's details last updated?
The information pertaining to the Bonnie Jan Berg, including its address, specialty, and other details, was most recently updated on 2008-05-08.