Provider Demographics
NPI:1750690517
Name:BERNIER, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BERNIER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2359
Mailing Address - Country:US
Mailing Address - Phone:860-324-0861
Mailing Address - Fax:
Practice Address - Street 1:100 WEST RD STE 3
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3798
Practice Address - Country:US
Practice Address - Phone:860-454-0520
Practice Address - Fax:860-454-8469
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist