Provider Demographics
NPI:1619371226
Name:BERNADETTE C. WINTERS, PHD., LCSW
Entity Type:Organization
Organization Name:BERNADETTE C. WINTERS, PHD., LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:CAPITO
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:805-651-8859
Mailing Address - Street 1:9044 MANN DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2312
Mailing Address - Country:US
Mailing Address - Phone:804-651-8859
Mailing Address - Fax:804-746-5150
Practice Address - Street 1:9044 MANN DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2312
Practice Address - Country:US
Practice Address - Phone:804-651-8859
Practice Address - Fax:804-746-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-11
Last Update Date:2014-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040081911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty