Provider Demographics
NPI:1023024247
Name:BERMAN, WILLIAM B (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:BERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6846 S CANTON AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3412
Mailing Address - Country:US
Mailing Address - Phone:918-745-0095
Mailing Address - Fax:918-745-0190
Practice Address - Street 1:6846 S CANTON AVE STE 501
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3431
Practice Address - Country:US
Practice Address - Phone:918-745-0095
Practice Address - Fax:918-745-0190
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK68103TF0000X
OK321103TF0200X, 103T00000X
OKLMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist