MEDICARE: LISA M. BERNATH M.ED., LPCC-S

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	E.0003199-SUPV	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E.0003199-SUPV	OTHER	OH	OHIO COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD

General Provider Information

NPI Number	:	1851521538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA M. BERNATH M.ED., LPCC-S

Provider Business Mailing Address
First Line	:	3208 ROBINA LN
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-8679
Country	:	US
Telephone Number	:	135-295-6182
Fax Number	:	513-824-8129

Provider Business Practice Location Address
First Line	:	4947 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-3908
Country	:	US
Telephone Number	:	513-757-9433
Fax Number	:	513-824-8129

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

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	07/11/2022

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