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NPI Code Detail

MEDICARE: LISA CATARINA BERNHARD BS

MEDICARE: LISA CATARINA BERNHARD BS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1235883752
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA CATARINA BERNHARD BS
Provider Business Mailing Address
First Line : 2951 W ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-7914
Country : US
Telephone Number : 541-254-0396
Fax Number :
Provider Business Practice Location Address
First Line : 37875 JASPER LOWELL RD
Second Line :
City : JASPER
State : OR
Zip : 97438-9751
Country : US
Telephone Number : 541-747-1235
Fax Number : 541-747-4722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2022
Last Update Date : 02/04/2022

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