Provider Demographics
NPI:1295053452
Name:BERNECHE, JONCI OWEN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JONCI
Middle Name:OWEN
Last Name:BERNECHE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23927-0405
Mailing Address - Country:US
Mailing Address - Phone:434-374-3222
Mailing Address - Fax:434-374-3223
Practice Address - Street 1:110 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927-9122
Practice Address - Country:US
Practice Address - Phone:434-374-3222
Practice Address - Fax:434-374-3223
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional