Individual provider Active NPI

Jodi Carol Berman, PHD

  • Psychologist
  • Westport, CT
National Provider Identifier
1467530519
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
003295 Issued in CT
Practice address
179 Post Rd W
2ND Floor
Westport, CT 06880-4602
Phone
(201) 248-7361
NPI assigned
Nov 2, 2006
Last updated
Aug 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 017830 NY
Psychologist 103T00000X 003295 CT Primary

Addresses

Primary practice location

179 Post Rd W
2ND Floor
Westport, CT 06880-4602

Mailing address

625 Towne House Rd
Fairfield, CT 06824-1894
Phone (201) 248-7361

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
17830NYMDPharmacist
003295CTMDSpeech-Language Pathologist
017830NYMDMedical Art Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1467530519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 TOWNE HOUSE RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068241894",
            "telephone_number": "201-248-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 POST RD W",
            "address_2": "2ND FLOOR",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804602",
            "telephone_number": "201-248-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "JODI",
        "middle_name": "CAROL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017830",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.