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General NPI Number Information
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NPI Number | 1750082707
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Entity Type | Individual
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Provider Name | TAMEDRA BIERNACKI LMFTA
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Gender | Female
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 6604 SIX FORKS RD STE 101
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City | RALEIGH
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State | NC
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Zip | 27615-6521
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Country | US
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Telephone | 984-235-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 6608 SIX FORKS RD STE 204
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City | RALEIGH
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State | NC
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Zip | 27615-6522
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Country | US
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Telephone | 919-435-2302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 20224A
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-215449
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License Number State | NC
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