Provider Demographics
NPI:1437879327
Name:BERGMAN, MEREDITH (LCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 FALMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2900
Mailing Address - Country:US
Mailing Address - Phone:301-704-6268
Mailing Address - Fax:
Practice Address - Street 1:244 MADISON AVE # 1047
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2817
Practice Address - Country:US
Practice Address - Phone:855-387-4378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1016051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical