MEDICARE: MS. BERNADETTE LATASHA VARNEDOE LCSW

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	101YM0800X	Mental Health Counselor	CSW009402	GA

General Provider Information

NPI Number	:	1992694582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BERNADETTE LATASHA VARNEDOE LCSW

Provider Business Mailing Address
First Line	:	225 SAPWOOD WAY
Second Line	:
City	:	HINESVILLE
State	:	GA
Zip	:	31313-1230
Country	:	US
Telephone Number	:	912-801-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 SAPWOOD WAY
Second Line	:
City	:	HINESVILLE
State	:	GA
Zip	:	31313-1230
Country	:	US
Telephone Number	:	912-801-1499
Fax Number	:

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

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/04/2026

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