Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Douglas Alan Bergstrom, PHD

Individual provider Clinical Psychologist · NPI 1063536688

Douglas Alan Bergstrom, PHD is a Clinical Psychologist in Prescott, Arizona. Qualified in 1983, 43 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
43
Licensed in
AZ
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

143 E Merritt St
Prescott, AZ 86301-2028 Not confirmed with CMS for 19 years — call before visiting
Phone: (928) 445-3835
Fax: (928) 445-7071
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 1142 (AZ)

Record details

NPI number1063536688
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedMarch 19, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients15
Services billed 292 a service is one billed item, such as a visit, a test or a procedure
Average patient age70

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

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