Provider Demographics
NPI:1750036323
Name:BERNARD, KATHERINE M (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:BERNARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 PALM VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8812
Mailing Address - Country:US
Mailing Address - Phone:941-504-2015
Mailing Address - Fax:
Practice Address - Street 1:1326 PALM VIEW RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8812
Practice Address - Country:US
Practice Address - Phone:941-504-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW154541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical