Individual provider Active NPI

William Morris Bernstein, PH.D.

  • Prescribing (Medical) Psychologist
  • Santa Fe, NM
National Provider Identifier
1164439600
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
0012C Issued in NM
Practice address
1435 S Saint Francis Dr BLDG Suite209
Santa Fe, NM 87505-4202
Phone
(505) 977-4523
Fax
(505) 503-7897
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0882 NM
Prescribing (Medical) Psychologist 103TP0016X 0012C NM Primary

Addresses

Primary practice location

1435 S Saint Francis Dr BLDG Suite209
Santa Fe, NM 87505-4202

Mailing address

1435 S Saint Francis Dr BLDG Suite209
Santa Fe, NM 87505-4202
Phone (505) 977-4523

Other identifiers 1

IdentifierTypeStateIssuer
48250538MedicaidNM

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

LicenseStateTypeSpecialty
008124NYMDMental Health Counselor
0882NMMDClinical Psychologist
0012CNMMDPrescribing (Medical) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1164439600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 S SAINT FRANCIS DR BLDG SUITE209",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054202",
            "telephone_number": "505-977-4523",
            "fax_number": "505-503-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 S SAINT FRANCIS DR BLDG SUITE209",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054202",
            "telephone_number": "505-977-4523",
            "fax_number": "505-503-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "WILLIAM",
        "middle_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "0882",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "0012C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48250538",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.