Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

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.

See every abbreviation used in this directory →

Practice location Address checks out

143 E Merritt St
Prescott, AZ 86301-2028
Phone: (928) 445-3835
Fax: (928) 445-7071
Show map & directions

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
Mailing address143 E Merritt St, Prescott, AZ 86301-2028

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

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