Organization · Type 2 NPI

Douglas A. Bergstrom, Ph.d., PLLC

Community/Behavioral Health Agency · Prescott, AZ

NPI number 1154501682 Active

Practice location

143 E Merritt St
Prescott, AZ 86301-2028

Call (928) 445-3835 Map

Fax (928) 445-7071

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency Primary 251S00000X1142 (AZ)

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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About NPI 1154501682

Douglas A. Bergstrom, Ph.d., PLLC's National Provider Identifier is 1154501682, issued on Nov 13, 2007. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Prescott, AZ. The record was last updated on Nov 13, 2007.