Olga Vadymovna Berkout, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

37551 Issued in TX

Practice address

2935 Bain PL
Tyler, TX 75701-8017

Phone

(662) 613-0008

NPI assigned

Dec 27, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Corinth, MS
  • NPI 1154601219
  NPD (past)
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Corinth, MS
  • NPI 1942579826
  NPD (past)

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1629372115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COUNTY ROAD 7283",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724055192",
            "telephone_number": "662-613-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 BAIN PL",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018017",
            "telephone_number": "662-613-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 County Road 7283",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724055192",
            "country_code": "US",
            "telephone_number": "662-613-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERKOUT",
        "first_name": "OLGA",
        "middle_name": "VADYMOVNA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew E Bentley, MD
• Constance S Bentley, APRN
• Mary Solan Bentley, CRNA
• Lenora Marie Berg, CRNA
• Sloan Mackenzie Berger, MS, CCC-SLP
• Alma Criseida Berlingeri Ramos, MD
• Valerie Bernadotte, MD
• Jarett D. Berry, MD
• Virginia Berry
• Sarah Michelle Berumen, MPAS, PA-C, RDMS

• Psychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.