Individual
AMANDA M BERNHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, MSW
Contact information
Practice address
1795 JET WING DR, COLORADO SPRINGS, CO 80916
(719) 284-6502
Mailing address
1795 JET WING DR, COLORADO SPRINGS, CO 80916-2332
(719) 572-6100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ACB.0008175
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0001073
CO
1041C0700X
Clinical Social Worker
CSW.09927006
CO
Other
Enumeration date
06/28/2017
Last updated
02/02/2023
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