LINDSAY RAY BERGMAN, LISW-S, LCSW — NPI 1710197173 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1710197173

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1041C0700X (CMS 80)

Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical

Box 32 Service Location & ZIP+4

190 WILSON RD, COLLINS, MS, 39428-6030

✓ 9-Digit EDI 837 ZIP+4 (39428-6030)

Practice Phone & Referral Fax

(601) 408-9616

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1710197173 (LINDSAY RAY BERGMAN, LISW-S, LCSW) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1710197173` (NPI-1 Individual Practitioner)
Provider / Legal Name	LINDSAY RAY BERGMAN, LISW-S, LCSW
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: `1041C0700X` (Social Worker, Clinical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	190 WILSON RD, COLLINS, MS, 39428-6030
Practice Telephone / Fax	Tel: (601) 408-9616
Administrative Mailing Address	7239 FERNBANK AVE, CINCINNATI, OH, 45233-1011
Enumeration & Last Sync	Enumerated: 2007-05-23 \| CMS Record Updated: 2022-10-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

190 WILSON RD, COLLINS, MS, 39428-6030

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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)

What Does Taxonomy Code 1041C0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 80 (Licensed Clinical Social Worker)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, Clinical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LINDSAY RAY BERGMAN, LISW-S, LCSW)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: MS \| License: `c6874` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: OH \| License: `I1450832SUPV` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LINDSAY RAY BERGMAN, LISW-S, LCSW (NPI #1710197173)