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1780910455 NPI number — BERTHLYN M BERNIER MSW

NPI Number: 1780910455
Health Care Provider/Practitioner: BERTHLYN M BERNIER MSW

Information about “1780910455” NPI (BERTHLYN M BERNIER MSW) exists in 1780910455 in HTML format HTML  |  1780910455 in plain Text format TXT  |  1780910455 in PDF (Portable Document Format) PDF  |  1780910455 in an XML format XML  formats.

NPI Number : 1780910455 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780910455",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BERNIER",
    "FirstName": "BERTHLYN",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BERNIER",
    "OtherFirstName": "BERTHLYN",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MSW/LICSW",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "121 RUSKIN RD.",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HYDE PARK",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02136",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "781-588-2216",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "184 DUDLEY ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROXBURY",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02119-2561",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "617-442-2002",
    "PracticeLocationAddressFaxNumber": "617-442-4002",
    "EnumerationDate": "10/30/2009",
    "LastUpdateDate": "10/30/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "111360",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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