Michael Berard, PH.D., M.P., a Professional Psychology Corporation

Key facts

NPI: 1699083261
Entity type: Organization (NPI type 2)
Primary specialty: Prescribing (Medical) Psychologist 103TP0016X
License: MPAP.000010 (LA)
Legal business name: MICHAEL BERARD, PH.D., M.P., A PROFESSIONAL PSYCHOLOGY CORPORATION
Practice address: 601 W Saint Mary Blvd
Suite 406
Lafayette, LA 70506-3568
Phone: (337) 233-7867
Fax: (337) 235-7199
NPI assigned: Sep 16, 2010
Organization subpart: No

Authorized official

Name: Dr. Michael Berard, PH.D., MPAP NPI 1720020159
Title: Medical Psychologist
Phone: (337) 233-7867

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Michael Berard, PH.D., M.P. Prescribing (Medical) Psychologist · Lafayette, LA · NPI 1720020159

Medicare reassignment NPD Authorized official COGNITIVE & BEHAVIORAL · LA

Medicare participation

Medicare fee-for-service enrollment: Enrolled in LA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20120131000274	LA	Part B Supplier - Clinic/Group Practice	7517124738	Receives reassigned benefits from 1 practitioner Practice locations: Lafayette, LA

National Provider Directory

Locations

601 W Saint Mary Blvd
Ste 406
Lafayette, LA 70506
Phone (337) 233-7867

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Cognitive & Behavioral Psychologist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	103TB0200X	MPAP.000010	LA
Clinical Psychologist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	103TC0700X	MPAP.000010	LA
Prescribing (Medical) Psychologist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	103TP0016X	MPAP.000010	LA	Yes

Addresses

Primary practice location

601 W Saint Mary Blvd
Suite 406
Lafayette, LA 70506-3568

Mailing address

PO Box 52612
Lafayette, LA 70505-2612
Phone (337) 233-7867

Other identifiers

Identifier	Type	State	Issuer
1929191	Medicaid	LA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 14, 2016.

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1699083261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52612",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052612",
            "telephone_number": "337-233-7867",
            "fax_number": "337-235-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W SAINT MARY BLVD",
            "address_2": "SUITE 406",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063568",
            "telephone_number": "337-233-7867",
            "fax_number": "337-235-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BERARD, PH.D., M.P., A PROFESSIONAL PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "BERARD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "337-233-7867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., MPAP"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "LA",
            "license": "MPAP.000010",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "MPAP.000010",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "MPAP.000010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1929191",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

All providers in Lafayette, LA · Prescribing (Medical) Psychologist in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.