Individual provider · Type 1 NPI
Charles Warren Bergeson, LAC
Addiction (Substance Use Disorder) Counselor · Fargo, ND
NPI number
1174963318
Active
Practice location
2624 9th Ave S
Fargo, ND 58103-2350
Fax (701) 298-4400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1174963318
Charles Warren Bergeson, LAC's National Provider Identifier is 1174963318, issued on Jul 2, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fargo, ND. The record was last updated on Aug 26, 2020.