Provider Demographics
NPI:1639356066
Name:BERNS, DANIEL ELIAS (LMSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ELIAS
Last Name:BERNS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 CARTER RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9556
Mailing Address - Country:US
Mailing Address - Phone:315-781-2926
Mailing Address - Fax:
Practice Address - Street 1:2635 CARTER RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-9556
Practice Address - Country:US
Practice Address - Phone:315-781-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050649-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical