Healthcare Provider Details
I. General information
NPI: 1366007882
Provider Name (Legal Business Name): REBEKAH GRACE BERNA LPC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/09/2019
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4810 LIBERTY AVE
PITTSBURGH PA
15224-2108
US
IV. Provider business mailing address
509 ALLENBY AVE
PITTSBURGH PA
15218-1303
US
V. Phone/Fax
- Phone: 412-578-9700
- Fax: 412-578-9800
- Phone: 312-351-4425
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | 16-143 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC009899 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: