Jeffrey S. Berryhill, PH.D, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5264 Issued in MN

Legal business name

JEFFREY S. BERRYHILL, PH.D, PLLC

Practice address

900 Long Lake Rd Ste 320
New Brighton, MN 55112-6439

Phone

(651) 482-9361

Fax

(651) 482-9888

NPI assigned

Apr 24, 2014

Organization subpart

No

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

Authorized official

Name

Jeffrey S. Berryhill, PH.D, LP

Title

Owner/Psychologist

Phone

(651) 482-9361

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1902226350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 320",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126439",
            "telephone_number": "651-482-9361",
            "fax_number": "651-482-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 320",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126439",
            "telephone_number": "651-482-9361",
            "fax_number": "651-482-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. BERRYHILL, PH.D, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "BERRYHILL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-482-9361",
        "authorized_official_credential": "PH.D, LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.