Provider Demographics
NPI:1528794450
Name:HARDMAN, BERNICE MAXINE (LMSW-CLINICAL)
Entity type:Individual
Prefix:MS
First Name:BERNICE
Middle Name:MAXINE
Last Name:HARDMAN
Suffix:
Gender:F
Credentials:LMSW-CLINICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13386 LAKE POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2286
Mailing Address - Country:US
Mailing Address - Phone:313-485-6899
Mailing Address - Fax:
Practice Address - Street 1:13386 LAKE POINT BLVD
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-2286
Practice Address - Country:US
Practice Address - Phone:313-485-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011095381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical