Provider Demographics
NPI:1316760143
Name:BERGER, HELEN (MA, LPC, R-DMT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MA, LPC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 N 67TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2849
Mailing Address - Country:US
Mailing Address - Phone:513-520-1870
Mailing Address - Fax:
Practice Address - Street 1:890 ELM GROVE RD STE 2&103B
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2528
Practice Address - Country:US
Practice Address - Phone:262-506-4419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18-37225600000X
WI10995-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist