Bergman, Lesa Gail

Bergman, Lesa Gail is an individual health care provider with primary practice located at 206 Centre On The Lk , Lake St Louis MO 63367-1370. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bergman, Lesa Gail can be contacted via phone (636) 699-2165.

Contact Information

Primary practice address
206 Centre On The Lk Lake St Louis MO 63367-1370
Phone: (636) 699-2165
Fax: (636) 625-1633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2001029221 Missouri

Profile Details

NPI number 1003981713
LBN Legal business name Bergman, Lesa Gail
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Jan 22nd, 2015 - about 9 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 1003981713 NPPES
Missouri MEDICAID 498442706
Missouri Other 89520

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