Provider Demographics
NPI:1053030817
Name:BERMAN, MORDECHAI (LPC)
Entity type:Individual
Prefix:MR
First Name:MORDECHAI
Middle Name:
Last Name:BERMAN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 KINGSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3095
Mailing Address - Country:US
Mailing Address - Phone:732-363-7872
Mailing Address - Fax:
Practice Address - Street 1:43 KINGSFIELD DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3095
Practice Address - Country:US
Practice Address - Phone:732-363-7872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01118900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist