Provider Demographics
NPI:1215818240
Name:SUZANNE BERGMANN LCSW PLLC
Entity type:Organization
Organization Name:SUZANNE BERGMANN LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-600-3407
Mailing Address - Street 1:2100 NESCONSET HWY # 1067
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3503
Mailing Address - Country:US
Mailing Address - Phone:631-600-3407
Mailing Address - Fax:631-980-0112
Practice Address - Street 1:800 VETERANS MEMORIAL HIGHWAY, SUITE 303
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-600-3407
Practice Address - Fax:631-980-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty