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General NPI Number Information
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NPI Number | 1851458442
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Entity Type | Individual
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Provider Name | MITCHELL BERDIE PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1653 MONTANE DR E
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City | GOLDEN
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State | CO
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Zip | 80401-8094
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Country | US
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Telephone | 303-358-0073
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Fax | 720-316-6620
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Provider Business Mailing Address
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Address Line | 1653 MONTANE DR E
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City | GOLDEN
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State | CO
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Zip | 80401-8094
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Country | US
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Telephone | 303-358-0073
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Fax | 720-316-6620
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 845
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 845
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License Number State | CO
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