Active NPI
Stephen Charles Bonsignore-Berry, PSY.D.
- Clinical Psychologist
- Brockton, MA
National Provider Identifier
1972650141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6229
- Practice address
- 209 Quincy St
Brockton, MA 02302-2926 - Phone
- (508) 584-2291
- Fax
- (508) 584-3480
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6229 | MA | Primary |
| Clinical Psychologist | 103TC0700X | 4586 | OH |
Addresses
Primary practice location
209 Quincy St
Brockton, MA 02302-2926
Mailing address
209 Quincy St
Brockton, MA 02302-2926
Phone (508) 584-2291
Other names 1
- Dr. Stephen C. Berry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4586 | OH | MD | Chiropractor |
| 6229 | MA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972650141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 QUINCY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022926",
"telephone_number": "508-584-2291",
"fax_number": "508-584-3480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 QUINCY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022926",
"telephone_number": "508-584-2291",
"fax_number": "508-584-3480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONSIGNORE-BERRY",
"first_name": "STEPHEN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "6229",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "4586",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHEN",
"last_name": "BERRY",
"middle_name": "C.",
"prefix": "DR.",
"credential": "PSY.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.