MR. Mark Wynn Berger, L.C.S.W.

NPI #1720414634 in Lewiston, Idaho

Provider Information

NPI Number: 1720414634
Entity Type: Individual
Name: MR. Mark Wynn Berger, L.C.S.W.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: L.C.S.W.
Enumeration Date: Sep 24, 2013
Last Updated: Sep 24, 2013

Practice Location

Address: 1002 IDAHO ST
City: Lewiston
State: Idaho
ZIP Code: 83501-1938
Phone: (208) 746-7661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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