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General NPI Number Information
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NPI Number | 1952339657
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Entity Type | Individual
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Provider Name | KEITH ALAN BERFIELD PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7305 NORTH MILITARY TRAIL VA MEDICAL CENTER, MENTAL HEALTH AND BEHAVIORAL SCIENCE
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6400
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Country | US
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Telephone | 561-422-6566
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Fax | 561-422-6992
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Provider Business Mailing Address
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Address Line | 3969 SW HALCOMB ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-4058
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Country | US
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Telephone | 772-344-5342
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Fax |
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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 | PS006494L
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License Number State | PA
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