Provider Demographics
NPI:1700891413
Name:BERKO PSYCHOLOGICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:BERKO PSYCHOLOGICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERKO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-668-8564
Mailing Address - Street 1:PO BOX 391057
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-8057
Mailing Address - Country:US
Mailing Address - Phone:440-668-8564
Mailing Address - Fax:877-844-4869
Practice Address - Street 1:6575 ASHTON LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3213
Practice Address - Country:US
Practice Address - Phone:440-668-8564
Practice Address - Fax:877-844-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2937380Medicaid
OH9351991Medicare PIN