Katherine Suzanne Bergs, PH.D., LMFT

Primary specialty

PsychologistTaxonomy code 103T00000X

License

37284 Issued in TX

Practice address

3301 Stalcup Rd
Fort Worth, TX 76119-1726

Phone

(817) 702-1100

Fax

(817) 920-0729

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine Buck Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment NPD

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1194911792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MAY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047639",
            "telephone_number": "817-702-2450",
            "fax_number": "817-702-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 STALCUP RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761191726",
            "telephone_number": "817-702-1100",
            "fax_number": "817-920-0729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Roslyn St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802383323",
            "country_code": "US",
            "telephone_number": "720-848-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2526 Southeast 26th Avenue",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97202",
            "country_code": "US",
            "telephone_number": "503-852-1168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGS",
        "first_name": "KATHERINE",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37284",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "5062A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BUCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Celeste Bergan, PH.D., CCC-SLP
• Brent Zane Bergen
• Lindsay D Bergin, LPC
• Edward Bergman, PHARMD
• Stephanie Kathleen Bergmann, OTR/L
• Grace Bergstedt
• Elizabeth Bergstrom, LPC
• Reed Jamison Berkley, CRNA
• Luigino Rolando Mateo Bernabela, M.D
• Amanda Yolanda Bernal, LPC

• Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.