Bergman, Daniel Paul

Bergman, Daniel Paul is an individual health care provider with primary practice located at 1247 Raleigh St , Green Bay WI 54304-3848. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Bergman, Daniel Paul can be contacted via phone (920) 497-0846.

Contact Information

Primary practice address
1247 Raleigh St Green Bay WI 54304-3848
Phone: (920) 497-0846
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3484-125 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3484-125 Wisconsin

Profile Details

NPI number 1710054101
LBN Legal business name Bergman, Daniel Paul
Credentials M.S., L.P.C., N.C.C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jan 8th, 2010 - about 16 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 1710054101 NPPES
Wisconsin MEDICAID 40979800

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