Provider Demographics
NPI:1821443342
Name:BERNHARDT, MONA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MONA
Middle Name:
Last Name:BERNHARDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TRUE
Other - Middle Name:
Other - Last Name:HARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2312 WESTERN TRAILS BLVD
Mailing Address - Street 2:BLDG D, STE 404
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1642
Mailing Address - Country:US
Mailing Address - Phone:512-969-0847
Mailing Address - Fax:
Practice Address - Street 1:400 N ALLEN DR STE 204
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2568
Practice Address - Country:US
Practice Address - Phone:972-233-1010
Practice Address - Fax:214-623-6692
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX569531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical