Active NPI
Hanan S. Berman, PH.D.
- Clinical Psychologist
- Kirkland, WA
National Provider Identifier
1063514974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0951
- Practice address
- 11415 NE 128TH St
Suite 100
Kirkland, WA 98034-6314 - Phone
- (425) 823-4869
- Fax
- (425) 823-4869
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0951 | WA | Primary |
Addresses
Primary practice location
11415 NE 128TH St
Suite 100
Kirkland, WA 98034-6314
Mailing address
11415 NE 128TH St
Suite 100
Kirkland, WA 98034-6314
Phone (425) 823-4869
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0031708 | Other | WA | LABOR & INDUSTRIES |
| 8902897 | Other | WA | CRIME VICTIM COMPENSATION |
| BE8122 | Other | WA | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0951 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063514974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11415 NE 128TH ST",
"address_2": "SUITE 100",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346314",
"telephone_number": "425-823-4869",
"fax_number": "425-823-4869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11415 NE 128TH ST",
"address_2": "SUITE 100",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346314",
"telephone_number": "425-823-4869",
"fax_number": "425-823-4869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "HANAN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "0951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0031708",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIM COMPENSATION",
"identifier": "8902897",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "BE8122",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.