Provider Demographics
NPI:1497402242
Name:BERNASCONI, STEPHANIE ALAYNA (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALAYNA
Last Name:BERNASCONI
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12300 SOUTH SHORE BLVD SUITE 222
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-473-4219
Mailing Address - Fax:
Practice Address - Street 1:6697 REMINGTON PL
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7340
Practice Address - Country:US
Practice Address - Phone:561-985-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2737574Other2737574