Provider Demographics
NPI:1598069122
Name:BERNARD, CALVIN J III (MS)
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:J
Last Name:BERNARD
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 ELSON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1945
Mailing Address - Country:US
Mailing Address - Phone:610-800-4016
Mailing Address - Fax:
Practice Address - Street 1:2288 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4108
Practice Address - Country:US
Practice Address - Phone:215-579-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health