Provider Demographics
NPI:1083793921
Name:LERNER, JOEY
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5277 MANHATTAN CIR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-8201
Mailing Address - Country:US
Mailing Address - Phone:303-543-5785
Mailing Address - Fax:303-543-5782
Practice Address - Street 1:5277 MANHATTAN CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8201
Practice Address - Country:US
Practice Address - Phone:303-543-5785
Practice Address - Fax:303-543-5782
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO267722084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry