Provider Demographics
NPI:1134506413
Name:BERNING, KIMBERLY JOY (LMSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOY
Last Name:BERNING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:JOY
Other - Last Name:VANDEN BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-3407
Mailing Address - Country:US
Mailing Address - Phone:616-994-2290
Mailing Address - Fax:269-966-4123
Practice Address - Street 1:155 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-3407
Practice Address - Country:US
Practice Address - Phone:616-994-2290
Practice Address - Fax:269-966-4123
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010934831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical