Berg, Evan
Berg, Evan is an individual health care provider with primary practice located at 1145 Sagamore Ave , Portsmouth NH 03801-5503. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Berg, Evan can be contacted via phone (603) 431-6703.Contact Information
Primary practice address
1145 Sagamore Ave
Portsmouth NH 03801-5503
Phone: (603) 431-6703
Fax: (603) 430-3753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2256 | New Hampshire |
Profile Details
| NPI number | 1497297873 |
|---|---|
| LBN Legal business name | Berg, Evan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2016 |
| Last updated | Jan 8th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497297873 | NPPES |
| New Hampshire | MEDICAID | 3078870 |
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