Provider Demographics
NPI:1194230730
Name:BERNARD, REBEKAH ROBIN (LMHC)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ROBIN
Last Name:BERNARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 UPTON ST UNIT 410
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01519-1481
Mailing Address - Country:US
Mailing Address - Phone:401-636-1682
Mailing Address - Fax:
Practice Address - Street 1:23 UPTON ST., #410
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:MA
Practice Address - Zip Code:01519
Practice Address - Country:US
Practice Address - Phone:401-636-1682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-443101YM0800X
MA13076-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health