Provider Demographics
NPI:1407161821
Name:BERA, LYNDA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:MARIE
Last Name:BERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 GIDNEY AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2805
Mailing Address - Country:US
Mailing Address - Phone:845-569-2900
Mailing Address - Fax:866-619-5710
Practice Address - Street 1:280 BROADWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5408
Practice Address - Country:US
Practice Address - Phone:845-562-8255
Practice Address - Fax:845-562-4140
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082816-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical