Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEFFREY ROBERT BERGSTROM, MSW LCSW MPA
Active Sole ProprietorJEFFREY ROBERT BERGSTROM, MSW LCSW MPA is a Clinical Social Worker healthcare provider located in MULLAN, Idaho. NPI 1558840850 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · MULLAN, ID
Registration Details
- NPI Number
- 1558840850
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 8, 2018 (8.0497874921795 yrs)
- Last Updated
- Dec 27, 2024
- Licenses
-
100963 (CA)4686 (HI)49993 (MT)40757 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
379 2ND STREETMULLAN, ID, 83846Browse ID providers · Browse ZIP 83846
- Phone
- 3072640114
- Primary Specialty
-
Clinical Social Worker
1041C0700X
- Additional Specialty
- Clinical Social Worker
- Additional Specialty
- Clinical Social Worker
- Additional Specialty
- Clinical Social Worker
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.