Provider Demographics
NPI:1790969061
Name:BERNHARDT, MINA MAY (MA, LMHC, CAP)
Entity Type:Individual
Prefix:MS
First Name:MINA
Middle Name:MAY
Last Name:BERNHARDT
Suffix:
Gender:F
Credentials:MA, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 CASTILLO AVE
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4315
Mailing Address - Country:US
Mailing Address - Phone:941-833-8400
Mailing Address - Fax:941-833-8499
Practice Address - Street 1:2208 CASTILLO AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4315
Practice Address - Country:US
Practice Address - Phone:941-833-8400
Practice Address - Fax:941-833-8499
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC3214101YA0400X
FL3236101YA0400X
CO1985101YM0800X
FLMH9163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)