DEREK BERGERON PH.D NPI 1477841823

NPI Information

  • NPI: 1477841823
  • Provider Name: DEREK BERGERON, PH.D
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 1650 COCHRANE CIR
    EVANS ARMY COMMUNITY HOSPITAL
    FORT CARSON, CO
    ZIP 80913
  • Phone: (719) 503-7920

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NPI Details

Derek Bergeron, PH.D is a clinical psychologist in Fort Carson, CO. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Derek Bergeron, PH.D NPI is 1477841823. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1650 COCHRANE CIR
EVANS ARMY COMMUNITY HOSPITAL
FORT CARSON, CO
ZIP 80913
Phone: (719) 503-7920

The enumeration date for this NPI number is 7/19/2011 and was last updated on 2/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPSY.0004175COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12865917MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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