Darin Bergen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1857 Issued in OR

Practice address

975 SE Sandy Blvd Ste 160
Portland, OR 97214-2498

Phone

(503) 341-6536

Fax

(503) 343-6272

NPI assigned

Apr 21, 2009

Last updated

May 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Portland, OR
  • NPI 1043501836
  NPD (past)
• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1659482925
  NPD (past)

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1205070265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 SE HAWTHORNE BLVD",
            "address_2": "PMB 425",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145246",
            "telephone_number": "503-341-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SE SANDY BLVD STE 160",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142498",
            "telephone_number": "503-341-6536",
            "fax_number": "503-343-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "DARIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren A. Berg, MA, LPA
• Naomi Berg, MA, QMHP
• Rachael Berg
• Reagan Christine Day Berg
• Samara Berg
• Brittany Berger, CPM, LM, LDM
• Daniel Berger
• Elizabeth Berger
• Kaitlin Willoughby Berger, L.M.T.
• Kendre Berger, MSW, QMHP

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.