Provider Demographics
NPI:1962426809
Name:BERGER, ANGELA M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:BERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:NIRCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6034 W EDDY ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4211
Mailing Address - Country:US
Mailing Address - Phone:773-725-0841
Mailing Address - Fax:
Practice Address - Street 1:950 E 61ST ST
Practice Address - Street 2:ROOM 207
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-2623
Practice Address - Country:US
Practice Address - Phone:773-753-4500
Practice Address - Fax:773-702-0208
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical