Individual
JEROME C BERNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW & LMFT
Contact information
Practice address
215 SE 2ND AVE, GRAND RAPIDS, MN 55744-3615
(218) 326-1274
(218) 326-8255
Mailing address
215 SE 2ND AVE, GRAND RAPIDS, MN 55744-3615
(218) 326-1274
(218) 326-8255
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
00563
MN
106H00000X
Marriage & Family Therapist
Primary
36
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009418
PREFERRED ONE
MN
01
—
62-20162
UNITED BEHAVIORAL HEALTH
MN
01
—
69264BE
BCBS OF MINNESOTA
MN
05
—
70235700
—
MN
Enumeration date
05/03/2007
Last updated
05/20/2008
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