Provider Demographics
NPI:1457059115
Name:BERNIE STRAND, LLC
Entity Type:Organization
Organization Name:BERNIE STRAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CSAC, CGP
Authorized Official - Phone:808-265-0868
Mailing Address - Street 1:41-038 WAILEA ST STE C
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1671
Mailing Address - Country:US
Mailing Address - Phone:808-265-0868
Mailing Address - Fax:808-791-8343
Practice Address - Street 1:41-038 WAILEA ST STE C
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1671
Practice Address - Country:US
Practice Address - Phone:808-265-0868
Practice Address - Fax:808-791-8343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI787195Medicaid