Provider Demographics
NPI:1992765788
Name:BERKMAN, CLAIRE FLEET (EDD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:FLEET
Last Name:BERKMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4572 SOUTH HAGADORN
Mailing Address - Street 2:2A EAST
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823
Mailing Address - Country:US
Mailing Address - Phone:517-349-8388
Mailing Address - Fax:517-349-1560
Practice Address - Street 1:4572 SOUTH HAGADORN
Practice Address - Street 2:2A EAST
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-349-8388
Practice Address - Fax:517-349-1560
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL537652103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
680C345150OtherBCBS
034605OtherOPTIONS
00538236788301OtherCONNECTICUT GENERAL
034605OtherOPTIONS