Provider Demographics
NPI:1023560158
Name:BERLAND, JODI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:BERLAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 GLADES RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7209
Mailing Address - Country:US
Mailing Address - Phone:561-392-7779
Mailing Address - Fax:561-447-9234
Practice Address - Street 1:2499 GLADES RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7209
Practice Address - Country:US
Practice Address - Phone:561-392-7779
Practice Address - Fax:561-447-9234
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist