Individual provider Active NPI

Brad Bernstein, PSY.D, LPC

  • Clinical Psychologist
  • Bala Cynwyd, PA
National Provider Identifier
1053484410
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016398 Issued in PA
Practice address
191 Presidential Blvd
Bala Cynwyd, PA 19004-1207
Phone
(484) 744-2086
NPI assigned
Nov 15, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC002468 PA
Clinical Psychologist 103TC0700X PS016398 PA Primary

Addresses

Primary practice location

191 Presidential Blvd
Bala Cynwyd, PA 19004-1207

Mailing address

41 Cornell Rd
Bala Cynwyd, PA 19004-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627001325 PA Practitioner - Clinical Psychologist 2163647512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

191 Presidential Blvd
Suite 124
Bala Cynwyd, PA 19004-1216
Phone (484) 744-2086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC002468PAMDProfessional Counselor
PS016398PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Psychological PC CurrentSince Apr 5, 2014 Accepting new patients
Belmont Behavioral Hospital, LLC CurrentSince Jul 1, 2015 Accepting new patients
Belmont Behavioral Hospital, LLC CurrentSince Jul 1, 2015 Accepting new patients
Dr Brad Bernstein PSYD LLC Clinical CurrentSince Mar 10, 2023 Accepting new patients

Locations

191 Presidential Blvd
Ste 124
Bala Cynwyd, PA 19004
Phone (484) 744-2086

101 W Chester Pike
Havertown, PA 19083
Phone 6105442110107

4200 Monument Rd
Philadelphia, PA 19131
Phone (215) 456-6611

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1053484410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CORNELL RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PRESIDENTIAL BLVD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041207",
            "telephone_number": "484-744-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-04-01",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC002468",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.