Provider Demographics
NPI:1992913347
Name:BERDEN, BARBARA R
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:BERDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5287 JUDITH BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-3118
Mailing Address - Country:US
Mailing Address - Phone:248-737-9019
Mailing Address - Fax:248-865-0325
Practice Address - Street 1:6661 INKSTER RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-2824
Practice Address - Country:US
Practice Address - Phone:248-737-9019
Practice Address - Fax:248-865-0325
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health