Provider Demographics
NPI:1154338002
Name:BERLIN, NORMA HARRIET (LCPC)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:HARRIET
Last Name:BERLIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 ONTARIO ST
Mailing Address - Street 2:APT 207
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2100
Mailing Address - Country:US
Mailing Address - Phone:708-848-4553
Mailing Address - Fax:708-848-1702
Practice Address - Street 1:210 W 22ND ST
Practice Address - Street 2:SUITE 120
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1544
Practice Address - Country:US
Practice Address - Phone:630-572-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health