Provider Demographics
NPI:1730522038
Name:BERGER PSYCHOLOGICAL SERVICES, P.C.
Entity type:Organization
Organization Name:BERGER PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-971-3303
Mailing Address - Street 1:4939 LOWER ROSWELL RD
Mailing Address - Street 2:SUITE B-202
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4338
Mailing Address - Country:US
Mailing Address - Phone:770-971-3303
Mailing Address - Fax:770-971-3314
Practice Address - Street 1:4939 LOWER ROSWELL RD
Practice Address - Street 2:SUITE B-202
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4338
Practice Address - Country:US
Practice Address - Phone:770-971-3303
Practice Address - Fax:770-971-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002956103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty