Provider Demographics
NPI:1306003785
Name:BERNER, AMYBETH LEVIE (MA, LPC, NBCC)
Entity Type:Individual
Prefix:
First Name:AMYBETH
Middle Name:LEVIE
Last Name:BERNER
Suffix:
Gender:F
Credentials:MA, LPC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-1122
Mailing Address - Country:US
Mailing Address - Phone:609-261-9523
Mailing Address - Fax:
Practice Address - Street 1:11000 LINCOLN DR W STE 5
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3431
Practice Address - Country:US
Practice Address - Phone:856-985-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00108200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional