John Michael Bergman, LICENSED PSYCHOLOGIS
Individual provider Active NPI Cognitive & Behavioral Psychologist · Marshalltown, IA
NPI 1215901202 · NPPES record last updated Oct 10, 2007
Key facts
- NPI
- 1215901202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cognitive & Behavioral Psychologist 103TB0200X
- License
- 00505 (IA)
- Practice address
- 9 N 4TH Ave
Marshalltown, IA 50158-1836 - Phone
- (641) 752-1585
- Fax
- (641) 752-9665
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00505 | IA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center Associates | Cognitive & Behavioral | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 00505 | IA | Yes |
Addresses
Primary practice location
9 N 4TH Ave
Marshalltown, IA 50158-1836
Mailing address
9 N 4TH Ave
Marshalltown, IA 50158-1836
Phone (641) 752-1585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037087 | Other | IA | HEALTH ALLIANCE |
| 05823 | Other | IA | BCBS |
| 0058230 | Medicaid | IA | |
| 05823 | Other | IA | MEDICARE |
| 234211 | Other | IA | MIDLANDS CHOICE |
| IA0101 | Other | IA | JOHN DEERE/UBH |
Other providers in Marshalltown, IA
- Beverly Bear
- Kristina Lucia Beck
- Claudia J Beckwith
- Sandra Marie Bennett
- Brandt Bergman
- Leah A. Bethel
- Leron Danielle Bierman
- Sarah Bischoff
- James F Black
- Tiana Bolar
All providers in Marshalltown, IA · Cognitive & Behavioral Psychologist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.