Provider Demographics
NPI:1194059279
Name:MAY, BERNADETTE M (LCSW)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:M
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 N MCLEAN BLVD
Mailing Address - Street 2:SUITE I
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1782
Mailing Address - Country:US
Mailing Address - Phone:847-695-3680
Mailing Address - Fax:847-695-4552
Practice Address - Street 1:1140 N MCLEAN BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1782
Practice Address - Country:US
Practice Address - Phone:847-695-3680
Practice Address - Fax:847-695-4552
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0123931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical