Provider Demographics
NPI:1336521392
Name:BERGLIND, ARIANA DOMINIQUE (MSW)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:DOMINIQUE
Last Name:BERGLIND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:
Other - Last Name:VISCIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 PARK AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3366
Mailing Address - Country:US
Mailing Address - Phone:413-213-2979
Mailing Address - Fax:
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-2781
Practice Address - Country:US
Practice Address - Phone:781-744-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 104100000X
MALICSW1240731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker