Provider Demographics
NPI:1457824328
Name:BERNADINE PICKETT, PLLC
Entity Type:Organization
Organization Name:BERNADINE PICKETT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERNADINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC NCC
Authorized Official - Phone:248-752-4881
Mailing Address - Street 1:63401 DEQUINDRE ROAD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48095-2203
Mailing Address - Country:US
Mailing Address - Phone:248-752-4881
Mailing Address - Fax:999-999-9999
Practice Address - Street 1:455 S LIVERNOIS RD STE C-12
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2582
Practice Address - Country:US
Practice Address - Phone:248-752-4881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty