NPI 1689737181 · live from the CMS NPI Registry
Sam David Bernard, M.A., Ph.D.
Psychologist, Clinical in Chattanooga, TN. National Provider Identifier 1689737181, active.
NPI record
| NPI | 1689737181 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 6148 Lee Hwy, Suite 208, Chattanooga, TN 37421 |
| Practice phone | 423-322-3297 |
| Mailing address | 212 Brently Woods Dr, Chattanooga, TN 37421 |
| Enumerated | December 18, 2006 |
| Last updated | December 30, 2014 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | 27004 NBCC |
| Psychologist, Clinical primary | 103TC0700X | PE1378 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.