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BLAKE BERNLOHR LCSW, LAC

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1366026742

Individual Registrant:
 BLAKE  BERNLOHR LCSW, LAC
Gender: M
Sole Proprietor

Location and contact information for practice:
111 VESTA RD  SALIDA, CO 81201-9327 US
Tel: 719-539-6502  Fax: --

Contact information for business:
111 VESTA RD  SALIDA, CO 81201-9327 US
Tel: 719-539-6502  Fax: --

Registration Information:
NPI: 1366026742
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator
COACD.0001780
N104100000XBehavioral Health & Social Service Providers
Social Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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