Berg, Phyllis Ann

Berg, Phyllis Ann is an individual health care provider with primary practice located at 7301 Forest Ave Suite 201, Richmond VA 23226-3792. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Berg, Phyllis Ann can be contacted via phone (804) 285-4121.

Contact Information

Primary practice address
7301 Forest Ave Suite 201 Richmond VA 23226-3792
Fax: (804) 285-4123
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Virginia

Profile Details

NPI number 1073523536
LBN Legal business name Berg, Phyllis Ann
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Jul 8th, 2007 - about 19 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 1073523536 NPPES
Virginia MEDICAID 77-1466-1

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