Berardi, Anthony Louis

Berardi, Anthony Louis is an sole proprietor health care provider with primary practice located at 300 S Saint Louis Blvd Suite 202, South Bend IN 46617-3043. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Berardi, Anthony Louis can be contacted via phone (574) 232-1405.

Contact Information

Primary practice address
300 S Saint Louis Blvd Suite 202 South Bend IN 46617-3043
Phone: (574) 232-1405
Fax: (574) 232-0124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20010290A Indiana

Profile Details

NPI number 1316995095
LBN Legal business name Berardi, Anthony Louis
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2006
Last updated Jun 24th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316995095 NPPES
Indiana MEDICAID 100095590

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