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General NPI Number Information
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NPI Number | 1942627401
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Entity Type | Individual
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Provider Name | ANDREA BERNKRANT LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/23/2014
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Last Update Date | 03/23/2014
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Provider Practice Location Address
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Address Line | 1680 W IRON SPRINGS RD STE.103
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City | PRESCOTT
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State | AZ
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Zip | 86305-3313
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Country | US
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Telephone | 928-273-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 1928 ESTRELLA RD
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City | PRESCOTT
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State | AZ
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Zip | 86305-5200
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Country | US
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Telephone | 928-273-5202
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12149
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License Number State | AZ
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