Provider Demographics
NPI:1508289802
Name:BERNSTEIN, ANNJEANETTE
Entity Type:Individual
Prefix:
First Name:ANNJEANETTE
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9620 ROCKHAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-7106
Mailing Address - Country:US
Mailing Address - Phone:720-297-4273
Mailing Address - Fax:
Practice Address - Street 1:9620 ROCKHAMPTON WAY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-7106
Practice Address - Country:US
Practice Address - Phone:720-297-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099232391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical