Individual provider Active NPI

Eileen F Bernat, PH.D.

  • Clinical Psychologist
  • Everett, WA
National Provider Identifier
1780612309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1738 Issued in WA
Practice address
127 E Intercity Ave
Suite a
Everett, WA 98208-2751
Phone
(425) 347-7275
Fax
(425) 355-0626
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1738 WA Primary

Addresses

Primary practice location

127 E Intercity Ave
Suite a
Everett, WA 98208-2751

Mailing address

127 E Intercity Ave
Suite a
Everett, WA 98208-2751
Phone (425) 347-7275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120301000607 WA Practitioner - Clinical Psychologist 6406013051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19105 36TH Ave W
Suite 213
Lynnwood, WA 98036-5760
Phone (425) 347-7275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1738WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eileen F. Bernat, PH.D., P.S. Clinical CurrentSince Dec 20, 2011 Accepting new patients

Locations

127 E Intercity Ave
Ste A
Everett, WA 98208
Phone (425) 347-7275

19105 36th Ave W
Ste 213
Lynnwood, WA 98036
Phone (425) 347-7275

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780612309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082751",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082751",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAT",
        "first_name": "EILEEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.