Provider Demographics
NPI:1952539025
Name:BETH M. BERMAN PSY.D. PC
Entity Type:Organization
Organization Name:BETH M. BERMAN PSY.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-505-8324
Mailing Address - Street 1:7112 BRANFORD CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1083
Mailing Address - Country:US
Mailing Address - Phone:248-505-8324
Mailing Address - Fax:248-926-2012
Practice Address - Street 1:425 W HURON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2242
Practice Address - Country:US
Practice Address - Phone:248-505-8324
Practice Address - Fax:248-926-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty