Provider Demographics
NPI:1710043195
Name:BERLEY, MADALINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MADALINE
Middle Name:
Last Name:BERLEY
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 1:155 EAST 55TH ST NE
Mailing Address - Street 2:SUITE 5J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4038
Mailing Address - Country:US
Mailing Address - Phone:212-759-4245
Mailing Address - Fax:212-759-9908
Practice Address - Street 1:155 EAST 55TH ST NE
Practice Address - Street 2:SUITE 5J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4038
Practice Address - Country:US
Practice Address - Phone:212-759-4245
Practice Address - Fax:212-988-3906
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032852103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN3I141Medicare ID - Type Unspecified