Bergdahl Assessment & Psychotherapy, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

BERGDAHL ASSESSMENT & PSYCHOTHERAPY, PLLC

Practice address

530 S Asbury St Ste 4a
Moscow, ID 83843-2243

Phone

(208) 310-2266

Fax

(888) 830-7441

NPI assigned

Apr 16, 2025

Last updated

Aug 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen A Bergdahl, PHDNPI 1346615655

Title

Clinical Psychologist

Phone

(559) 288-1747

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Alexander Bergdahl, PH.D.

  • Clinical Psychologist
  • Moscow, ID
  • NPI 1346615655
  NPD Authorized official

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1568258457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 WESTVIEW DR",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838439623",
            "telephone_number": "559-288-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S ASBURY ST STE 4A",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432243",
            "telephone_number": "208-310-2266",
            "fax_number": "888-830-7441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2254 Westview Dr",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838439623",
            "country_code": "US",
            "telephone_number": "559-288-1747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BERGDAHL ASSESSMENT & PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGDAHL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "559-288-1747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Moscow, ID
• Providers in Moscow, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.