Provider Demographics
NPI:1992208821
Name:BERNEKING, ELIZABETH ANN (MS, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BERNEKING
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSRN
Mailing Address - Street 1:8805 CAMELLIA DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-1003
Mailing Address - Country:US
Mailing Address - Phone:812-867-3138
Mailing Address - Fax:
Practice Address - Street 1:8805 CAMELLIA DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-1003
Practice Address - Country:US
Practice Address - Phone:812-867-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000898A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health