DR. ENNIS BERKER (NPI# 1316039357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316039357 |
| Entity Type | Individual |
| Full Name | DR. ENNIS BERKER |
| Credential | PH.D. |
| Practice Address |
1008 Merlin Way Dexter MI 48130-9834 |
| Practice Telephone | 2692172992 |
| Practice Fax Number | 7346230108 |
| Mailing Telephone | 2692172992 |
| Mailing Fax Number | 7346230108 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6301006050 | MI | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | 6301 006050 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | C 94573 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7320 Garden Ln, Suite 110, Portage, MI 490024423 | 2692172992 | 2693247707 |
| Street Address |
1008 MERLIN WAY |
| City | DEXTER |
| State | MI |
| Zip Code | 48130-9834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053843003 | Comprehensive Neuropsy Chological Services PC | Community/Behavioral Health | 1008 Merlin Way, Dexter, MI 48130-9834 | 2017-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013497585 | Julie Anne Bumpus X | Nurse Practitioner | 4848 Gregory, Dexter, MI 48130 | 2018-08-15 |
| 1255726592 | Alliance for Hope and Healing | Psychologist | 8005 Main St., Dexter, MI 48130 | 2015-04-03 |
| 1588979926 | Beata Malgorzata Jagoda-ohman | Physical Therapist | 7057 Dexter-ann Arbor Rd, Dexter, MI 48130 | 2010-08-10 |
| 1639317514 | Thrive Chiropractic Dexter P.C. | Preferred Provider Organization | 3219 Broad St, Suite 106, Dexter, MI 48130 | 2009-01-30 |
| 1083888622 | Alan Stephen Boyce | Chiropractor | 3151 Baker Rd, Dexter, MI 48130 | 2008-04-15 |
| 1720200785 | Brenda Denise Eisele | Speech-Language Pathologist | 3630 Noble Drive, Dexter, MI 48130 | 2007-05-02 |
| 1104041649 | Robert Joseph Turck | Dentist | 3060 Baker Rd, Dexter, MI 48130 | 2007-04-17 |
| 1073647343 | Amy Alexandra Whitney | Pharmacist | 7080 Dexter- Ann Arbor Rd, Dexter, MI 48130 | 2007-03-16 |
| 1457481442 | John Douglas Higgins | Audiologist | 7900 W Huron River Dr, Dexter, MI 48130 | 2007-03-07 |
| 1235264425 | Boyce Dc Pllc | Chiropractor | 3151 Baker Road, Dexter, MI 48130 | 2007-02-21 |
| Find all providers in zip 48130 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046098 | Axon Psychology Group, PC | Clinical Neuropsychologist | 1377 Stonecreek Ct, Saint Joseph, MI 49085-9795 | 2020-08-31 |
| 1548814965 | Emily Nicole Robinett-ferrara | Clinical Neuropsychologist | 14050 Kingston St, Oak Park, MI 48237-1140 | 2019-07-25 |
| 1649782244 | Matthew Kadrich | Clinical Neuropsychologist | 3334 Rochester Rd # 205, Troy, MI 48083-5426 | 2017-11-04 |
| 1992237176 | Lauren Marie Golla | Clinical Neuropsychologist | 111 E Court St Ste 1b, Flint, MI 48502-1649 | 2017-03-28 |
| 1750839783 | Ace Psychological Consultants LLC | Clinical Neuropsychologist | 1920 Livernois Rd Ste D, Troy, MI 48083-1770 | 2016-09-20 |
| 1922556406 | Kenya Hameed | Clinical Neuropsychologist | 111 East Court St, Suite 1b-1, Flint, MI 48502 | 2016-09-14 |
| 1841609369 | Crystal Young | Clinical Neuropsychologist | 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 | 2014-08-08 |
| 1497165146 | Woojin Song | Clinical Neuropsychologist | 2101 Commonwealth Blvd Ste C, Ann Arbor, MI 48105-2969 | 2014-05-03 |
| 1831516152 | Ira Lourie, Psy.d., Pllc | Clinical Neuropsychologist | 30051 High Valley Rd, Farmington Hills, MI 48331-2144 | 2014-03-25 |
| 1306272042 | Erin Mark | Clinical Neuropsychologist | 2010 Hogback Rd Ste 6g, Ann Arbor, MI 48105-8800 | 2013-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.