Provider Demographics
NPI:1285664896
Name:BERNE, PHILIP H (LISW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:H
Last Name:BERNE
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 5 MILE RD
Mailing Address - Street 2:240
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2163
Mailing Address - Country:US
Mailing Address - Phone:513-232-3070
Mailing Address - Fax:513-232-5794
Practice Address - Street 1:8000 5 MILE RD
Practice Address - Street 2:240
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2163
Practice Address - Country:US
Practice Address - Phone:513-232-3070
Practice Address - Fax:513-232-5794
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI3098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBESW15012Medicare ID - Type Unspecified