Provider Demographics
NPI:1699977249
Name:BERSON, JANET SUSAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:SUSAN
Last Name:BERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 EAST MAIN STREET
Mailing Address - Street 2:STE D
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3031
Mailing Address - Country:US
Mailing Address - Phone:856-778-7652
Mailing Address - Fax:856-778-7653
Practice Address - Street 1:715 EAST MAIN STREET
Practice Address - Street 2:STE D
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3031
Practice Address - Country:US
Practice Address - Phone:856-778-7652
Practice Address - Fax:856-778-7653
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1469103T00000X, 103TF0000X, 103TF0200X
PAPS002940L103T00000X, 103TF0000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic