MS. THERESA BERGOLD (NPI# 1831613868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831613868 |
| Entity Type | Individual |
| Full Name | MS. THERESA BERGOLD |
| Credential | LMSW |
| Practice Address |
161 Lake Shore Rd Lake Ronkonkoma NY 11779-3182 |
| Mailing Address |
10 Railroad Ave Apt 4 Bethpage NY 11714-3000 |
| Practice Telephone | 6314715666 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
161 LAKE SHORE RD |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-3182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265970834 | Damian Family Care Center, Inc. | Clinic/Center | 161 Lake Shore Rd, Lake Ronkonkoma, NY 11779-3182 | 2017-02-03 |
| 1134640980 | Saturne Phillip | Social Worker | 161 Lake Shore Rd, Lake Ronkonkoma, NY 11779-3182 | 2017-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578622 | Roberto Javier Torres | Counselor | 115 Angelacrest Ln, West Seneca, NY 14224-3819 | 2020-11-05 |
| 1386245595 | Liliana Maria Calle | Counselor | 1510 Waters Pl Fl 2, Bronx, NY 10461-2700 | 2020-11-04 |
| 1245831528 | Multi Assistance Resource Centers Inc. | Counselor | 509 Willis Ave Fl 4, Bronx, NY 10455-4001 | 2020-11-04 |
| 1952902371 | Brandon Chevere | Counselor | 175 Remsen St Fl 9, Brooklyn, NY 11201-4333 | 2020-11-03 |
| 1619577541 | Josselyn D Carias-rodriguez | Counselor | 90 Cherry Ln, Hicksville, NY 11801-6232 | 2020-10-29 |
| 1275133688 | Carol Hunt | Counselor | 76 Humboldt Pkwy, Buffalo, NY 14214-2605 | 2020-10-27 |
| 1598363806 | Anabel Lago-pedrick | Counselor | 539 County Road 40, Maplecrest, NY 12454-1245 | 2020-10-09 |
| 1386241511 | Kelly Jensen | Counselor | 255 Delaware Ave Ste 3000, Buffalo, NY 14202-2016 | 2020-10-01 |
| 1538776091 | James Mcrae | Counselor | 100 N Portland Ave Rm B228, Brooklyn, NY 11205-2005 | 2020-09-29 |
| 1215544036 | Jeanette Malpica-oskowitz | Counselor | 100 N Portland Ave # B217, Brooklyn, NY 11205-2005 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
Please comment or provide details below to improve the information on MS. THERESA BERGOLD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.