Amy Bernstein

Individual provider Active NPI Mental Health Counselor · Stillwater, MN

NPI 1962051615 · NPPES record last updated Sep 5, 2019

Key facts

NPI
1962051615
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
10707-120 (WI)
Practice address
14949 62ND St N
Stillwater, MN 55082-6102
Phone
(651) 430-6613
Fax
(651) 430-6527
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10707-120WIMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10707-120 WI Yes

Addresses

Primary practice location

14949 62ND St N
Stillwater, MN 55082-6102

Mailing address

14949 62ND St N
Stillwater, MN 55082-6102
Phone (651) 430-6613

Other names

  • Amy Shafer Former name

Other providers in Stillwater, MN

All providers in Stillwater, MN · Mental Health Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.