Individual provider Active NPI

Kelly Marie Bernhard, LCSW-R

  • Clinical Social Worker
  • Amherst, NY
National Provider Identifier
1568978997
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071956 Issued in NY
Practice address
575 Alberta Dr Ste 2
Amherst, NY 14226-1139
Phone
(716) 832-0720
Fax
(716) 832-5867
NPI assigned
Dec 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 071956 NY Primary

Addresses

Primary practice location

575 Alberta Dr Ste 2
Amherst, NY 14226-1139

Mailing address

575 Alberta Dr Ste 2
Amherst, NY 14226-1139
Phone (716) 832-0720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071956NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1568978997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ALBERTA DR STE 2",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261139",
            "telephone_number": "716-832-0720",
            "fax_number": "716-832-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 ALBERTA DR STE 2",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261139",
            "telephone_number": "716-832-0720",
            "fax_number": "716-832-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHARD",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.