MS. Theresa Bergold, LMSW

NPI #1831613868 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1831613868
Entity Type: Individual
Name: MS. Theresa Bergold, LMSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LMSW
Enumeration Date: Aug 1, 2017
Last Updated: Aug 2, 2024

Practice Location

Address: 161 LAKE SHORE RD
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-3182
Phone: (631) 471-5666

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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