Provider Demographics
NPI:1245392109
Name:BERLAND, WARREN (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:BERLAND
Suffix:
Gender:M
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BECKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:NY
Mailing Address - Zip Code:12571-4149
Mailing Address - Country:US
Mailing Address - Phone:212-645-5332
Mailing Address - Fax:
Practice Address - Street 1:231 W 29TH ST
Practice Address - Street 2:RM 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5551
Practice Address - Country:US
Practice Address - Phone:212-645-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR024845-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN04651Medicare ID - Type UnspecifiedPROVIDER NUMBER