Ms. Dorothy J Bergold, LICSW
Clinic/Center, Primary Care in Revere, Massachusetts
1902389463- Practice location
- 385 Broadway, Revere, MA 02151-3033
- Phone
- 781-485-1000
- Fax
- —
- Last updated
- September 11, 2018
Dorothy Joan Bergold is a Clinic/Center, Primary Care based in Revere, MA. Dorothy Joan Bergold practices in Revere, MA and has the professional credentials of LICSW. The NPI Number for Dorothy Joan Bergold is 1902389463 and holds a License No. 105125 (MA). The current practice location address for Dorothy Joan Bergold is 385 Broadway, Revere, MA 02151-3033 and can be reached out via phone at 781-485-1000.
Provider Profile Details
- NPI Number
- 1902389463
- Provider Name
- Dorothy Joan Bergold
- Credential
- LICSW
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 385 Broadway, Revere, MA 02151-3033
- Phone Number
- 781-485-1000
- Primary Taxonomy
- Clinic/Center, Primary Care · 261QP2300X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- September 11, 2018
- Last Update Date
- September 11, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 385 Broadway
Revere, MA 02151-3033 - City
- Revere
- State
- Massachusetts
- Zip
- 02151-3033
- Phone Number
- 781-485-1000
Provider Business Mailing Address Details
- Address
- 13 Hersam St
Stoneham, MA 02180-2441 - City
- Stoneham
- State
- MA
- Zip
- 02180-2441
- Phone Number
- 781-438-9006
License Information
- License Number
- 105125
- License State
- MA
- Taxonomy
- Clinic/Center, Primary Care · 261QP2300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ms. Dorothy J Bergold, LICSW?
The NPI number of Ms. Dorothy J Bergold, LICSW is 1902389463. It was assigned on September 11, 2018 and is currently active in the NPPES registry.
What is the specialty of Ms. Dorothy J Bergold, LICSW?
Ms. Dorothy J Bergold, LICSW is registered under the primary taxonomy Clinic/Center, Primary Care (code 261QP2300X), licensed in MA under license number 105125.
Where does Ms. Dorothy J Bergold, LICSW practice?
The practice location is 385 Broadway, Revere, MA 02151-3033. The office can be reached at 781-485-1000 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1902389463 directly on the NPPES registry website.