MEDICARE: DR. VICKI R. BERNARD PH.D, LMFT,LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	CS001695	MO
2	106H00000X	Marriage & Family Therapist		MO

General Provider Information

NPI Number	:	1174685747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICKI R. BERNARD PH.D, LMFT,LPC

Provider Business Mailing Address
First Line	:	4144 LINDELL BLVD
Second Line	:	SUITE 140
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2927
Country	:	US
Telephone Number	:	314-956-8100
Fax Number	:	314-389-8744

Provider Business Practice Location Address
First Line	:	4144 LINDELL BLVD
Second Line	:	SUITE 140
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2927
Country	:	US
Telephone Number	:	314-956-8100
Fax Number	:	314-389-8744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	09/11/2025

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