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General NPI Number Information
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NPI Number | 1407915598
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Entity Type | Individual
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Provider Name | MELVYN ALAN BERKE PH.D
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/05/2010
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Provider Practice Location Address
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Address Line | 12820 HILLCREST RD C-226
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City | DALLAS
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State | TX
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Zip | 75230-1526
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Country | US
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Telephone | 972-387-0177
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Fax | 972-386-8665
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Provider Business Mailing Address
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Address Line | 12820 HILLCREST RD C-226
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City | DALLAS
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State | TX
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Zip | 75230-1526
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Country | US
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Telephone | 972-387-0177
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Fax | 972-386-8665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2-0190
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 2-0190
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 2-0190
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 2-0190
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 2-0190
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 2-0190
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License Number State | TX
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