Individual
DR. DOUGLAS B. BERNON
Active
Individual
DR. DOUGLAS B. BERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
425
RI
103TP0814X
Psychoanalysis Psychologist
425
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3609-8192
AMERICAN PSYCHOLOGICAL ASSOCIATION
—
01
—
42653
COUNCIL FOR THE NATIONAL REGISTER OF HEALTH SERVICE PROVIDERS IN PSYCHOLOGY
—
01
—
LICENSE 425
STATE OF RHODE ISLAND DEPARTMENT OF HEALTH
RI
Enumeration date
01/02/2009
Last updated
03/02/2012
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