Provider Demographics
NPI:1003983503
Name:LERNER, LISA GAYLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:GAYLE
Last Name:LERNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 LITTLEWORTH LN
Mailing Address - Street 2:
Mailing Address - City:SEA CLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:11579-1943
Mailing Address - Country:US
Mailing Address - Phone:516-671-4084
Mailing Address - Fax:631-499-1357
Practice Address - Street 1:216 LITTLEWORTH LN
Practice Address - Street 2:
Practice Address - City:SEA CLIFF
Practice Address - State:NY
Practice Address - Zip Code:11579-1943
Practice Address - Country:US
Practice Address - Phone:516-671-4084
Practice Address - Fax:631-499-1357
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0516751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical