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NPI Code Detail

MEDICARE: DR. CHANTELLE ELAM BERNARD ED.D

MEDICARE:  DR. CHANTELLE ELAM BERNARD  ED.D
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
1101YP2500XProfessional Counselor0701008688VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10701008688OTHERVAVA LICENSE NUMBER

General Provider Information

NPI Number : 1811523087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHANTELLE ELAM BERNARD ED.D
Provider Business Mailing Address
First Line : 4860 COX RD STE 200
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9248
Country : US
Telephone Number : 804-747-1922
Fax Number : 804-747-6182
Provider Business Practice Location Address
First Line : 4860 COX RD STE 200
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9248
Country : US
Telephone Number : 804-747-1922
Fax Number : 804-747-6182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2020
Last Update Date : 10/12/2022

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Directions to “ DR. CHANTELLE ELAM BERNARD ED.D” Practice Location

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