DR. KATHLEEN RAE BERGESON (NPI# 1427055995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427055995 |
| Entity Type | Individual |
| Full Name | DR. KATHLEEN RAE BERGESON |
| Credential | PHD |
| Practice Address |
11 Reitz Blvd Lewisburg PA 17837-9293 |
| Practice Telephone | 5705240881 |
| Practice Fax Number | 5705249738 |
| Mailing Telephone | 5705240881 |
| Mailing Fax Number | 5705249738 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 012260 | NY | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
PS015237 | PA | Behavioral Health & Social Service Providers |
| Street Address |
11 REITZ BLVD |
| City | LEWISBURG |
| State | PA |
| Zip Code | 17837-9293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164634200 | Kathleen Bergeson, Phd P C | Psychologist | 11 Reitz Blvd, Suite 101, Lewisburg, PA 17837-9293 | 2007-05-03 |
| 1730137852 | Cheryl A. Hoover | Social Worker | 11 Reitz Blvd, Suite 101, Lewisburg, PA 17837-9293 | 2006-05-04 |
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|---|---|---|---|---|
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| 1184185910 | Laura Pulaski | Physical Therapy Assistant | 15 Rivercrest Cir, Lewisburg, PA 17837 | 2019-03-26 |
| 1487112892 | Taylor Karin Hendrix | Physical Therapy Assistant | 189 Tressler Dr, Lewisburg, PA 17837 | 2019-03-05 |
| 1902375033 | United States Penitentiary | Pharmacist | 2400 Robert F. Miller Drive, Lewisburg, PA 17837 | 2018-11-19 |
| 1114419710 | Society Hill Dental In Lewisburg | Dentist | 339 Market Street, Lewisburg, PA 17837 | 2018-05-31 |
| 1669919213 | Karen Jean Orchard | Marriage & Family Therapist | 821 Buffalo Road, Lewisburg, PA 17837 | 2017-01-20 |
| 1063892057 | Giant Food Stores LLC | Durable Medical Equipment & Medical Supplies | 224 Hardwood Dr, Lewisburg, PA 17837 | 2015-06-04 |
| 1003207853 | Lenora Jeanne Broda | Counselor | 1800 Market St, Diakon Family Life Services, Lewisburg, PA 17837 | 2015-02-16 |
| 1225457401 | Geisinger Clinic | Clinic/Center | 1717 W Market St, Lewisburg, PA 17837 | 2014-04-15 |
| 1982045456 | Abdul Rahim Ali | Counselor | 32 Whisper Creek, Suite 8, Lewisburg, PA 17837 | 2013-07-12 |
| Find all providers in zip 17837 | ||||
| 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 |
|---|---|---|---|---|
| 1366060220 | Yinka Read | Clinical Neuropsychologist | 1088 W. Baltimore Pike, Healthcare II, Suite 2205, Media, PA 19063 | 2020-07-08 |
| 1821617804 | Fit-minded, LLC | Clinical Neuropsychologist | 101 Forrest Ave, Narberth, PA 19072-2213 | 2020-04-10 |
| 1982238887 | Jesse Matthew Main | Clinical Neuropsychologist | 2150 Harrisburg Pike Fl 2, Lancaster, PA 17601-2644 | 2020-02-28 |
| 1467092312 | Katie Fabius | Clinical Neuropsychologist | 230 S Broad St Ste 1005, Philadelphia, PA 19102-4105 | 2020-01-08 |
| 1972155380 | Community Diagnostic Center for Children | Clinical Neuropsychologist | 160 N Craig St Ste 118, Pittsburgh, PA 15213-2714 | 2019-07-15 |
| 1164995023 | Mindful Neuropsychological Services, PC | Clinical Neuropsychologist | 940 E Haverford Rd Ste 303, Bryn Mawr, PA 19010-3859 | 2019-01-03 |
| 1497231666 | Julie Heier | Clinical Neuropsychologist | Department of Psychiatry 100 N Academy Ave, Danville, PA 17822-1335 | 2018-07-11 |
| 1699266189 | Eran Shlomo Auday | Clinical Neuropsychologist | 100 N Academy Ave Dept Of, Danville, PA 17822-1335 | 2018-05-21 |
| 1275033524 | Carla Towsey | Clinical Neuropsychologist | 200 Corporate Cir, Harrisburg, PA 17110-9796 | 2018-02-13 |
| 1093239824 | Ryan P.j. Stocker | Clinical Neuropsychologist | 135 Cumberland Rd Ste 108, Pittsburgh, PA 15237-5447 | 2017-08-02 |
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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.