Berkshire Psychodynamic Psychiatry Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

218113 Issued in MA

Legal business name

BERKSHIRE PSYCHODYNAMIC PSYCHIATRY INC

Practice address

48 Main St
Stockbridge, MA 01262-9701

Phone

(413) 464-2876

Fax

(413) 728-5580

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mark Bruckel Elliot, M.D.NPI 1073597845

Title

President

Phone

(413) 464-2876

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Mark Bruckel Elliot, MD

  • Psychiatry Physician
  • Stockbridge, MA
  • NPI 1073597845
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1801280391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962",
            "city": "STOCKBRIDGE",
            "state": "MA",
            "postal_code": "012620962",
            "telephone_number": "413-464-2876",
            "fax_number": "413-728-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MAIN ST",
            "city": "STOCKBRIDGE",
            "state": "MA",
            "postal_code": "012629701",
            "telephone_number": "413-464-2876",
            "fax_number": "413-728-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKSHIRE PSYCHODYNAMIC PSYCHIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "ELLIOT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BRUCKEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-464-2876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "218113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myrna Ayari, MSW LICSW
• John Azer
• Joanna Marie Barzottini, L.M.T.
• Marina Bayeva, MD, PHD
• Berkshire Hills Regional School District
• Berkshire Whole Health PC
• Heidi Berman-Rose, M.S.W.
• Christina Louise Biedermann, PSY.D.
• Michael Blake, PSY.D.
• Abigail Bliss, MS

• Psychiatry Physician in Stockbridge, MA
• Providers in Stockbridge, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare 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.