Provider Demographics
NPI:1043422405
Name:BERNIER, ROBIN (MA, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BERNIER
Suffix:
Gender:F
Credentials:MA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35301 N 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-2119
Mailing Address - Country:US
Mailing Address - Phone:623-670-1046
Mailing Address - Fax:623-434-7468
Practice Address - Street 1:35301 N 30TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-2119
Practice Address - Country:US
Practice Address - Phone:623-670-1046
Practice Address - Fax:623-434-7468
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-107751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical