Healthcare Provider Details

I. General information

NPI: 1194041301
Provider Name (Legal Business Name): JASON S BERMAN, PHD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 RICHARDSON DR STE 230
RICHARDSON TX
75080-4659
US

IV. Provider business mailing address

1475 RICHARDSON DR STE 230
RICHARDSON TX
75080-4659
US

V. Phone/Fax

Practice location:
  • Phone: 214-929-9244
  • Fax:
Mailing address:
  • Phone: 214-929-9244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1945
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2011006684
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number34212
License Number StateTX

VIII. Authorized Official

Name: DR. JASON S BERMAN
Title or Position: OWNER/LICENSED PSYCHOLOGIST
Credential: PH.D
Phone: 214-929-9244