Search › Idaho › 1041C0700X
Jeffrey Bergstrom, MSW LCSW MPA
NPI 1558840850 · on the registry since 2018 · sole proprietor
Practice
- Address
- 379 2nd Street
Mullan, ID 83846 - Phone
- (307) 264-0114
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
1041C0700X
1041C0700X - Licence states on file
- CA, HI, MT, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-12-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho