Provider Demographics
NPI:1659469120
Name:TRAYNOR, BERNADETTE E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:E
Last Name:TRAYNOR
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 1:520 STANTON STATION RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-237-5073
Mailing Address - Fax:
Practice Address - Street 1:4401 BRONX BLVD
Practice Address - Street 2:OUR LADY OF MERCY MENTAL HEALTH CLINIC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470
Practice Address - Country:US
Practice Address - Phone:718-304-7012
Practice Address - Fax:718-304-7065
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0410731104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker