Healthcare Provider Details

I. General information

NPI: 1154190072
Provider Name (Legal Business Name): KIMBERLY BERNAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 COMMERCIAL DR STE D8
SAVANNAH GA
31406-3645
US

IV. Provider business mailing address

315 COMMERCIAL DR STE D8
SAVANNAH GA
31406-3645
US

V. Phone/Fax

Practice location:
  • Phone: 912-604-0901
  • Fax: 912-988-8161
Mailing address:
  • Phone: 912-604-0901
  • Fax: 912-988-8161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLPC014268
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: