Individual provider Active NPI

Carla M Bernardes, PHD

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1255527420
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9382 Issued in MA
Practice address
1371 Beacon St
Suite 305
Brookline, MA 02446-4905
Phone
(617) 232-2436
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9382 MA Primary

Addresses

Primary practice location

1371 Beacon St
Suite 305
Brookline, MA 02446-4905

Mailing address

1371 Beacon St
Suite 305
Brookline, MA 02446-4905
Phone (617) 232-2436

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9382MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1255527420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 305",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 305",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDES",
        "first_name": "CARLA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.