Healthcare Provider Details

I. General information

NPI: 1598867525
Provider Name (Legal Business Name): BERNADETTE CLAIRE HANSEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BERNADETTE CLAIRE STOKER

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 SEBRING AVE
SEBRING FL
33875-4820
US

IV. Provider business mailing address

4318 SEBRING AVE
SEBRING FL
33875-4820
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-3897
  • Fax: 863-382-3897
Mailing address:
  • Phone: 863-382-3897
  • Fax: 863-382-3897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8651
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4929
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: