Provider Demographics
NPI:1710055108
Name:BERGER, NEIL (PHD, MS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:PHD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 BRUSH HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1447
Mailing Address - Country:US
Mailing Address - Phone:413-528-3932
Mailing Address - Fax:413-528-3932
Practice Address - Street 1:83 BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1447
Practice Address - Country:US
Practice Address - Phone:914-391-6747
Practice Address - Fax:413-528-3932
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8402103TC0700X, 103TC2200X, 103TP0814X, 103TA0700X
NY7208103TC0700X, 103TC2200X, 103TP0814X, 103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging