Provider Demographics
NPI:1750742516
Name:BERNARD, FREDERICK MATTHEW (PSYD)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:MATTHEW
Last Name:BERNARD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 BLAKE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-4889
Mailing Address - Country:US
Mailing Address - Phone:720-502-4927
Mailing Address - Fax:
Practice Address - Street 1:3501 BLAKE ST STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-4889
Practice Address - Country:US
Practice Address - Phone:720-502-4927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist