Provider Demographics
NPI:1447136080
Name:BERGER, MARY KEEGAN
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KEEGAN
Last Name:BERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 COMMONWEALTH DR APT 305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2397
Mailing Address - Country:US
Mailing Address - Phone:513-568-4302
Mailing Address - Fax:
Practice Address - Street 1:699 BERKMAR CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1406
Practice Address - Country:US
Practice Address - Phone:434-906-6617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health