Provider Demographics
NPI:1780379552
Name:BERNARD, JAMIE (MS, CMHW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BERNARD
Suffix:
Gender:
Credentials:MS, CMHW
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 676
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-0676
Mailing Address - Country:US
Mailing Address - Phone:307-438-3526
Mailing Address - Fax:
Practice Address - Street 1:160 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3112
Practice Address - Country:US
Practice Address - Phone:307-349-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYCMHW-073101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor