Provider Demographics
NPI:1104638980
Name:BERGER, HAKEMA (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:HAKEMA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:HAKEMA
Other - Middle Name:
Other - Last Name:HENDRICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 E LAHARPE ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4520
Mailing Address - Country:US
Mailing Address - Phone:660-665-1962
Mailing Address - Fax:
Practice Address - Street 1:500 CLARK AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1004
Practice Address - Country:US
Practice Address - Phone:636-584-8724
Practice Address - Fax:636-584-8725
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240470301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical