Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2-0190 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2-0190 | TX |
Y | 103G00000X | Clinical Psychologist | 2-0190 | TX |
Y | 103TC0700X | Clinical Psychologist | 2-0190 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2-0190 | TX |
N | 103TF0000X | Family Psychologist | 2-0190 | TX |
N | 103TH0100X | Health Service | 2-0190 | TX |
NPI | 1407915598 |
---|---|
Provider Name | Dr. Melvyn Alan Berke |
First Address | Dallas, TX 75230-1526 |
Second Address | Dallas, TX 75230-1526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 05/12/2010 |