Provider Demographics
NPI:1124506316
Name:BERMAN, LAURA (ASW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17145 OTSEGO ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3420
Mailing Address - Country:US
Mailing Address - Phone:818-422-7163
Mailing Address - Fax:
Practice Address - Street 1:17145 OTSEGO ST
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3420
Practice Address - Country:US
Practice Address - Phone:818-422-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical