Bergold, Theresa

Bergold, Theresa is an individual health care provider with primary practice located at 161 Lake Shore Rd , Lake Ronkonkoma NY 11779-3182. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Bergold, Theresa can be contacted via phone (631) 471-5666.

Contact Information

Primary practice address
161 Lake Shore Rd Lake Ronkonkoma NY 11779-3182
Phone: (631) 471-5666
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1831613868
LBN Legal business name Bergold, Theresa
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2017
Last updated Aug 1st, 2017 - about 7 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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