Hannah Ellen Bergman, PHD

Individual provider Active NPI Clinical Psychologist · Bozeman, MT

NPI 1104468370 · NPPES record last updated Nov 22, 2019

Key facts

NPI
1104468370
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PY60812437 (WA)
Practice address
300 N Willson Ave Ste 703G
Bozeman, MT 59715-3551
Phone
(406) 582-5312
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY60812437WAMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY60812437 WA Yes

Addresses

Primary practice location

300 N Willson Ave Ste 703G
Bozeman, MT 59715-3551

Mailing address

300 N Willson Ave Ste 703G
Bozeman, MT 59715-3551

Other providers in Bozeman, MT

All providers in Bozeman, MT · Clinical Psychologist in Montana

Sources for this page

Verify at the official NPI Registry.