Individual
BERNADETTE SENIOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
2587 RAVENHILL DR, FAYETTEVILLE, NC 28303-5451
(910) 323-1543
(910) 485-1257
Mailing address
6799 WOODBRIDGE WAY #103, FAYETTEVILLE, NC 28314-1994
(910) 867-1254
(910) 485-1257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5141
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1422H
BCBS
NC
05
—
6103067
—
NC
Enumeration date
08/24/2006
Last updated
07/08/2007
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