Provider Demographics
NPI:1851521538
Name:BERNATH, LISA M (MED, LPCC-S)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:BERNATH
Suffix:
Gender:F
Credentials:MED, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 ROBINA LN
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8679
Mailing Address - Country:US
Mailing Address - Phone:135-295-6182
Mailing Address - Fax:513-824-8129
Practice Address - Street 1:4947 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3908
Practice Address - Country:US
Practice Address - Phone:513-757-9433
Practice Address - Fax:513-824-8129
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003199-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE.0003199-SUPVOtherOHIO COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD