Amy Bergstrom , LPC
Counselor - Professional • Wayne, PA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Amy Bergstrom has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Amy Bergstrom, LPC was a registered Counselor - Professional practicing in Wayne, PA. Throughout an active medical career spanning 1 years, Amy Bergstrom provided care at the practice location at 300 N WAYNE AVE APT 5 until profile deactivation on 2017-11-08.
Practice Location & Contact Primary Location
300 N Wayne Ave Apt 5
Wayne, PA 190873239
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor - Professional in Wayne, PA
Practicing in Wayne, PA (9514 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2023-10-31NUCC Taxonomy Code: 101YP2500X
Definition to come...
NUCC Taxonomy Code: 101YM0800X
Definition to come...
NUCC Taxonomy Code: 101YP2500X
Definition to come...
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Registered at 300 N WAYNE AVE APT 5, WAYNE, PA 190873239 (Tel: 8155752014)
Registered at 300 N WAYNE AVE APT 5, WAYNE, PA 190873239 (Tel: 8155752014)
Counselor
Registered at 1777 SENTRY PKWY W STE 300, BLUE BELL, PA 194222211 (Tel: 2157677096)
Recorded as AMY BERGSTROM, LPC
Counselor (License #PC012237 in PA)
Record officially reactivated for active practice on November 14, 2017
Registered at 5022 CAMPBELL BLVD STE L, NOTTINGHAM, MD 212364969 (Tel: 4434421568)
Registered at 5022 CAMPBELL BLVD STE L, NOTTINGHAM, MD 212364969
Recorded as AMY BERGSTROM, LGPC
Counselor
Record deactivated on November 08, 2017
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
300 N Wayne Ave Apt 5
Wayne, PA 190873239
Phone: 8155752014
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