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:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:PAPAIKOU
Mailing Address - State:HI
Mailing Address - Zip Code:96781-0215
Mailing Address - Country:US
Mailing Address - Phone:808-756-2315
Mailing Address - Fax:
Practice Address - Street 1:15-1679 19TH AVENUE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-756-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-443101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health