Provider Demographics
NPI:1851591457
Name:BERNIER, CHRISTOPHER TAYLOR (MED)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:TAYLOR
Last Name:BERNIER
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-1320
Mailing Address - Country:US
Mailing Address - Phone:413-733-5469
Mailing Address - Fax:
Practice Address - Street 1:311 STATE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1320
Practice Address - Country:US
Practice Address - Phone:413-733-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health