Provider Demographics
NPI:1194911792
Name:BERGS, KATHERINE SUZANNE (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SUZANNE
Last Name:BERGS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1412 MAY ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7639
Mailing Address - Country:US
Mailing Address - Phone:817-702-2450
Mailing Address - Fax:817-702-7315
Practice Address - Street 1:3301 STALCUP RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-1726
Practice Address - Country:US
Practice Address - Phone:817-702-1100
Practice Address - Fax:817-920-0729
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37284103T00000X
NC5062A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist