Healthcare Provider Details

I. General information

NPI: 1740823137
Provider Name (Legal Business Name): KAYLYN BERNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2439 MANHATTAN BLVD STE 207
HARVEY LA
70058-5361
US

IV. Provider business mailing address

2626 CANAL ST.
NEW ORLEANS LA
70119
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-8949
  • Fax:
Mailing address:
  • Phone: 504-525-2366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13697
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number13967
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: