Bergum, Rebecca T

Bergum, Rebecca T is an individual health care provider with primary practice located at 798 Leerville Rd Peachtree Counseling Center Inc, Lynchburg VA 24502. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Bergum, Rebecca T can be contacted via phone (434) 239-1928.

Contact Information

Primary practice address
798 Leerville Rd Peachtree Counseling Center Inc Lynchburg VA 24502
Phone: (434) 239-1928
Fax: (434) 239-8779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0701002384 Virginia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0717000523 Virginia

Profile Details

NPI number 1356411169
LBN Legal business name Bergum, Rebecca T
Credentials LPC LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Jul 8th, 2007 - about 18 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 1356411169 NPPES
Virginia Other 11525477 CAQH
Virginia Other 282972 CAQH

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