Healthcare Provider Details

I. General information

NPI: 1932311255
Provider Name (Legal Business Name): BARBARA SUSAN BERNBAUM LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 LOOKOUT PL
MAITLAND FL
32751-4492
US

IV. Provider business mailing address

260 LOOKOUT PL STE 202
MAITLAND FL
32751-4485
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-1781
  • Fax: 407-647-1781
Mailing address:
  • Phone: 833-769-3524
  • Fax: 407-232-9437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH1293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: