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NPI Code Detail

MEDICARE: ETHAN BERNAUER

MEDICARE:   ETHAN  BERNAUER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist287692KY

General Provider Information

NPI Number : 1124808365
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHAN BERNAUER
Provider Business Mailing Address
First Line : 8621 OAKS WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-3397
Country : US
Telephone Number : 502-689-6300
Fax Number :
Provider Business Practice Location Address
First Line : 8621 OAKS WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-3397
Country : US
Telephone Number : 502-689-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2023
Last Update Date : 06/01/2026

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Directions to “ ETHAN BERNAUER ” Practice Location

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