Individual
BERNNELL KINDZRED JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2215 LANGHORNE RD, LYNCHBURG, VA 24501-1121
(434) 948-4831
Mailing address
2215 LANGHORNE RD, LYNCHBURG, VA 24501-1121
(434) 948-4831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701007735
VA
101YP2500X
Professional Counselor
Primary
0701007735
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437137734
—
VA
Enumeration date
06/28/2018
Last updated
12/29/2021
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