Provider Demographics
NPI:1598867525
Name:HANSEN, BERNADETTE CLAIRE (LMHC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:CLAIRE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:CLAIRE
Other - Last Name:STOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4318 SEBRING AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-4820
Mailing Address - Country:US
Mailing Address - Phone:863-382-3897
Mailing Address - Fax:863-382-3897
Practice Address - Street 1:4318 SEBRING AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-4820
Practice Address - Country:US
Practice Address - Phone:863-382-3897
Practice Address - Fax:863-382-3897
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8651101YM0800X
FL4929101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00590OtherBCBS
FL767644100Medicaid