Provider Demographics
NPI:1770670135
Name:BERNINI, GIA H (LICSW)
Entity Type:Individual
Prefix:
First Name:GIA
Middle Name:H
Last Name:BERNINI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 GILRAIN TER
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3431
Mailing Address - Country:US
Mailing Address - Phone:413-519-3529
Mailing Address - Fax:877-251-8058
Practice Address - Street 1:94 KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3284
Practice Address - Country:US
Practice Address - Phone:413-519-3529
Practice Address - Fax:877-251-8058
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1027633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1027633OtherSTATE SOCIAL WORK LICENSE