Doctor profile · Federal record

Dr. Douglas Bergstrom, PH.D.

Clinical Psychologist · Prescott, AZ

  • NPI 1063536688
  • Accepts Medicare
  • 43 yrs in practice
  • Male
  • Solo practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
143 E Merritt St
Prescott, AZ 863012028
(928) 445-3835
fax (928) 445-7071

Credentials & registration

NPPES · NUCC
NPI registered
March 2007 — 19 yrs on file
Profile last updated
July 8, 2007
Year of graduation
1983 — 43 yrs since
Specialty taxonomy
103TC0700X — NUCC code
State license (1)
Arizona #1142

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1063536688. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
323
Distinct HCPCS
2
Medicare allowed
$32,320
HCPCS Description Services Patients Avg allowed
90834 Psychotherapy, 45 minutes 311 22 $97
90791 Psychiatric diagnostic evaluation 12 12 $171

In context: peer comparison

Among 2 peers in Prescott Clinical Psychologist, average services per provider: 175. This provider delivers 1.8× the peer median.

Frequently asked questions

Auto-generated from federal data
What is Dr. Douglas Bergstrom's medical specialty?
Dr. Douglas Bergstrom practices Clinical Psychologist in Prescott, AZ.
Where does Dr. Douglas Bergstrom practice?
Dr. Douglas Bergstrom practices at 143 E Merritt St, Prescott, AZ 863012028. Office phone: 9284453835.
What is Dr. Douglas Bergstrom's NPI?
Dr. Douglas Bergstrom's National Provider Identifier (NPI) is 1063536688, issued by NPPES.
Does Dr. Douglas Bergstrom accept Medicare assignment?
Yes. Dr. Douglas Bergstrom accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Douglas Bergstrom commonly perform?
Top Medicare-reported procedures in 2023: Psychotherapy (HCPCS 90834); Psychiatric diagnostic evaluation (HCPCS 90791). Source: CMS Medicare Physician & Other Practitioners file.