Provider Demographics
NPI:1952339657
Name:BERFIELD, KEITH ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALAN
Last Name:BERFIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3969 SW HALCOMB ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4058
Mailing Address - Country:US
Mailing Address - Phone:772-344-5342
Mailing Address - Fax:
Practice Address - Street 1:7305 NORTH MILITARY TRAIL
Practice Address - Street 2:VA MEDICAL CENTER, MENTAL HEALTH AND BEHAVIORAL SCIENCE
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6400
Practice Address - Country:US
Practice Address - Phone:561-422-6566
Practice Address - Fax:561-422-6992
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006494L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical