Active NPI
Deborah Berntson, PHD
- Clinical Psychologist
- Fayetteville, NC
National Provider Identifier
1164401337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1622
- Practice address
- 592 Executive PL
Suite 101
Fayetteville, NC 28305-5188 - Phone
- (910) 323-6006
- Fax
- (910) 323-1921
- NPI assigned
- Jan 16, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 1622 | NC | Primary |
Addresses
Primary practice location
592 Executive PL
Suite 101
Fayetteville, NC 28305-5188
Mailing address
592 Executive PL
Suite 101
Fayetteville, NC 28305-5188
Phone (910) 323-6006
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0326K | Other | NC | BLUE CROSS BLUE SHIELD |
| 6000722 | Medicaid | NC |
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 |
|---|---|---|---|
| 1622 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1164401337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "592 EXECUTIVE PL",
"address_2": "SUITE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055188",
"telephone_number": "910-323-6006",
"fax_number": "910-323-1921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "592 EXECUTIVE PL",
"address_2": "SUITE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055188",
"telephone_number": "910-323-6006",
"fax_number": "910-323-1921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNTSON",
"first_name": "DEBORAH",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0326K",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000722",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.