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General NPI Number Information
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NPI Number | 1245181957
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Entity Type | Organization
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Legal Business Name | BERCK PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 02/07/2026
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 451 MAIN ST
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City | BEACON
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State | NY
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Zip | 12508-7309
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Country | US
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Telephone | 917-470-2404
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Fax | 866-285-9202
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Provider Business Mailing Address
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Address Line | PO BOX 59
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City | BECKET
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State | MA
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Zip | 01223-0059
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Country | US
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Telephone | 917-470-2404
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Fax | 866-285-9202
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JONATHAN S. BERCK
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Credential | JD
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Telephone | 917-470-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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