MEDICARE: BRIANNA BERNHARDT

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1467040352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA BERNHARDT

Provider Business Mailing Address
First Line	:	808 S 4TH ST UNIT 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 S 4TH ST UNIT 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3104
Country	:	US
Telephone Number	:	443-617-0776
Fax Number	:

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

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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Directions to “ BRIANNA BERNHARDT ” Practice Location

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