Provider Demographics
NPI:1699190223
Name:STRAND, BERNICE (LCSW, CSAC, CGP)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:STRAND
Suffix:
Gender:F
Credentials:LCSW, CSAC, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-038 WAILEA ST STE C
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1671
Mailing Address - Country:US
Mailing Address - Phone:808-265-0868
Mailing Address - Fax:808-791-8343
Practice Address - Street 1:41-038 WAILEA ST STE C
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1671
Practice Address - Country:US
Practice Address - Phone:808-265-0868
Practice Address - Fax:808-791-8343
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1519-10101YA0400X
HI38391041C0700X, 1041C0700X
WYLCSW-2601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI787195Medicaid