Vickie L. Bergen, PHD, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301008768 Issued in MI

Legal business name

VICKIE L. BERGEN, PHD, PLLC

Practice address

25882 Orchard Lake Rd
Suite 210
Farmington Hills, MI 48336-1292

Phone

(248) 444-7711

NPI assigned

Jan 30, 2009

Organization subpart

No

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

Authorized official

Name

Vickie L Bergen, PHD

Title

Clinical Psychologist

Phone

(248) 444-7711

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1487892311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE 210",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "248-444-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE 210",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "248-444-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKIE L. BERGEN, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "BERGEN",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-444-7711",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.