MR. BRADLEY J BERGESON (NPI# 1205052420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205052420 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY J BERGESON |
| Credential | MED, LMHP, LADC |
| Practice Address |
2101 Court St Sioux City IA 51104-3243 |
| Mailing Address |
2841 S Saint Aubin St Sioux City IA 51106-3420 |
| Practice Telephone | 7122934700 |
| Mailing Telephone | 7122234308 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2016-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
608 | NE | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
3721 | NE | Behavioral Health & Social Service Providers |
| Street Address |
2101 COURT ST |
| City | SIOUX CITY |
| State | IA |
| Zip Code | 51104-3243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003877291 | Kimberly Joan Devries | Social Worker | 2101 Court St, Sioux City, IA 51104-3243 | 2006-03-29 |
| 1255825816 | Laura Ann Mcardle | Counselor | 2101 Court St, Sioux City, IA 51104-3243 | 2018-06-18 |
| 1154852531 | Amy Small | Counselor | 2101 Court St, Sioux City, IA 51104-3243 | 2017-03-27 |
| 1104357599 | Tiffany Holbrook | Counselor | 2101 Court St, Sioux City, IA 51104-3243 | 2017-03-27 |
| 1700334083 | Brianna Mae Peterson | Counselor | 2101 Court St, Sioux City, IA 51104-3243 | 2016-09-15 |
| 1598132110 | Christina M Spicer | Counselor | 2101 Court St, Sioux City, IA 51104-3243 | 2015-08-31 |
| 1649603283 | Jackson Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 2101 Court St, Sioux City, IA 51104-3243 | 2013-08-19 |
| 1689716169 | Dean Watchorn Newbrey | Social Worker | 2101 Court St, Sioux City, IA 51104-3243 | 2007-02-13 |
| 1235271305 | Family Service's Inc | Clinic/Center | 2101 Court St, Sioux City, IA 51104-3243 | 2007-02-13 |
| 1184701245 | Boys and Girls Home and Family Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2101 Court St, Sioux City, IA 51104-3243 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578944435 | Family First Dental Associates of Iowa, P.C. | Dentist | 2100 Indian Hills Drive, Sioux City, IA 51104 | 2015-06-16 |
| 1740590785 | Khatu Vivienne Erlbacher | Pharmacist | 515 North Briar Path, Sioux City, IA 51104 | 2010-10-08 |
| 1730407545 | Randall Glen Wood | Emergency Medicine | 2720 Stone Park Blvd., Sioux City, IA 51104 | 2010-05-04 |
| 1790811024 | Fred R Rizk | Dentist | 1923 Nebraska Street, Siuox City, IA 51104 | 2007-02-23 |
| 1255474029 | Edilia Maria Marshall | Dentist | Summit Dental, 2114 Pierce St, Sioux City, IA 51104 | 2007-02-14 |
| 1063553410 | Thomas Leonard Tiedeman | Dentist | 2918 Hamilton Blvd, Upper D Suite 1, Sioux City, IA 51104 | 2007-02-09 |
| 1336209188 | Shawn Robert Walton | Dentist | 2410 Pierce Street, Sioux City, IA 51104 | 2006-12-11 |
| 1477649556 | Timothy R Kuntz | Dentist | 3012 Hamilton Blvd, Sioux City, IA 51104 | 2006-10-05 |
| 1528162732 | Duane Kent Nelson | Orthopaedic Surgery | 2800 Peirce St, Suite 101, Sioux City, IA 51104 | 2006-09-08 |
| 1659482206 | Shawn R Walton | Dentist | 2928 Hamilton Blvd, Suite 102, Sioux City, IA 51104 | 2006-08-31 |
| Find all providers in zip 51104 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982159125 | Tina Wickersham | Counselor | 4323 Vine Ave, Sioux City, IA 51106-1958 | 2016-08-17 |
| 1063865954 | Anna Tronson | Counselor | 4038 Division St, Sioux City, IA 51104-1581 | 2016-07-15 |
| 1144613795 | Melissa Jenkins | Counselor | 520 Nebraska St, Suite 408, Sioux City, IA 51101-1307 | 2015-03-06 |
| 1104214154 | Aaron Baker | Counselor | 1551 Indian Hills Dr Ste 221, Sioux City, IA 51104-1857 | 2014-12-29 |
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1851535256 | Angela D. Gronborg-harder | Counselor | 3549 Southern Hills Dr., Sioux City, IA 51106-4736 | 2009-04-29 |
| 1891863668 | Vivian Lea Miller | Counselor | 705 Douglas St, Suite 350, Sioux City, IA 51101 | 2006-12-01 |
| 1730143546 | Dorothy Westin-yockey | Counselor | 4301 Sergeant Rd, Suite 203, Sioux City, IA 51106-4726 | 2006-04-17 |
| 1871190389 | Kelly Jean Knaack | Counselor | 1115 5th St, Sioux City, IA 51101-1905 | 2020-10-07 |
| 1295346815 | Rebecca Ann Simoni-ryan | Counselor | 1115 5th St, Sioux City, IA 51101-1905 | 2020-08-17 |
| Find all providers in SIOUX CITY | ||||
| City | SIOUX CITY |
| Zip Code | 51104 |
Please comment or provide details below to improve the information on MR. BRADLEY J BERGESON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.