Provider Demographics
NPI:1174679450
Name:BERNARD, TRISHA T (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:T
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:TAYLOR
Other - Last Name:BERNARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSW
Mailing Address - Street 1:105 KATELYN LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8849
Mailing Address - Country:US
Mailing Address - Phone:859-277-3613
Mailing Address - Fax:859-277-3613
Practice Address - Street 1:101 WIND HAVEN DR STE 202
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-8036
Practice Address - Country:US
Practice Address - Phone:859-420-3613
Practice Address - Fax:855-476-5683
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1881235Z00000X
KY2584061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist