Michael S. Bergman, PH.D.

Key facts

NPI

1265631014

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Psychologist 103TC0700X

License

33417 (TX)

Practice address

2630 Exposition Blvd Ste 116
Austin, TX 78703-1758

Phone

(512) 417-2723

NPI assigned

Jul 12, 2007

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Philosophy

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 22, 2026.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1265631014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 ANN ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014608",
            "telephone_number": "512-417-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 EXPOSITION BLVD STE 116",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787031758",
            "telephone_number": "512-417-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

• Jacoby Dale Bergeron, DC
• Patricia L Bergh, CRNA
• Sabine Andrea Berghammer, NP
• Barbara L. Bergin-Nader, M.D.
• Emma Berglund, RD
• Maricela Bergstrom, MSN APRN FNP-BC
• Rahel Berhane, MD
• Jessica Beristain Herrera, RD, LD
• Laura Berkebile, L.AC
• Michell Berkley

All providers in Austin, TX · Clinical Psychologist in Texas