Provider Demographics
NPI:1740567148
Name:BERARD, CHRISTINA M (LMHC, LCDP, MAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:M
Last Name:BERARD
Suffix:
Gender:F
Credentials:LMHC, LCDP, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 DEWEY ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-7415
Mailing Address - Country:US
Mailing Address - Phone:401-996-5487
Mailing Address - Fax:401-216-9194
Practice Address - Street 1:1395 ATWOOD AVE STE 209D
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-4931
Practice Address - Country:US
Practice Address - Phone:401-241-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00643101YA0400X
RIMHC00902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)