Provider Demographics
NPI:1073199535
Name:KERNER, AMANDA BETH (LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:KERNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BETH
Other - Last Name:ROMANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:909 S STRONG AVE
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-4020
Mailing Address - Country:US
Mailing Address - Phone:516-606-5123
Mailing Address - Fax:
Practice Address - Street 1:909 S STRONG AVE
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-4020
Practice Address - Country:US
Practice Address - Phone:516-606-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009093101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health