Provider Demographics
NPI:1396843728
Name:BERKOWITZ, LORRAINE SHOOK (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:SHOOK
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 COVENTRY LANE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496
Mailing Address - Country:US
Mailing Address - Phone:561-620-3248
Mailing Address - Fax:
Practice Address - Street 1:225 N E MIZNER BLVD
Practice Address - Street 2:#300
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432
Practice Address - Country:US
Practice Address - Phone:561-620-3248
Practice Address - Fax:561-620-9335
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6167103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4134Medicare ID - Type Unspecified