Provider Demographics
NPI:1275029852
Name:BERNARD, LYCHELE (LMSW)
Entity Type:Individual
Prefix:
First Name:LYCHELE
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LYCHELE
Other - Middle Name:
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:145 ELMIRA LOOP APT 9A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-2005
Mailing Address - Country:US
Mailing Address - Phone:917-626-1137
Mailing Address - Fax:
Practice Address - Street 1:255 E 98TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-8817
Practice Address - Country:US
Practice Address - Phone:718-881-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092974104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker