| Berkshire Psychodynamic Psychiatry Inc | |
|
48 Main St Stockbridge MA 01262-9701 | |
| (413) 464-2876 | |
| (413) 728-5580 |
| Full Name | Berkshire Psychodynamic Psychiatry Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 48 Main St, Stockbridge, Massachusetts |
| Authorized Official Name and Position | Mark Bruckel Elliot (PRESIDENT) |
| Authorized Official Contact | 4134642876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berkshire Psychodynamic Psychiatry Inc Po Box 962 Stockbridge MA 01262-0962 Ph: (413) 464-2876 | Berkshire Psychodynamic Psychiatry Inc 48 Main St Stockbridge MA 01262-9701 Ph: (413) 464-2876 |
| NPI Number | 1801280391 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Medicare PECOS PAC ID | 6507187226 |
|---|---|
| Medicare Enrollment ID | O20150608000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801280391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 218113 (Massachusetts) | Primary |
| Provider Name | Mark B Elliot |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073597845 PECOS PAC ID: 1456336767 Enrollment ID: I20120510000197 |
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