Provider Demographics
NPI:1124853163
Name:HALASH, BERNADETTE (LLMSW)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:HALASH
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2267 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-4123
Mailing Address - Country:US
Mailing Address - Phone:734-363-8413
Mailing Address - Fax:
Practice Address - Street 1:1545 KINGSWAY CT # 207
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1952
Practice Address - Country:US
Practice Address - Phone:734-307-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511190481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical