Provider Demographics
NPI:1851843700
Name:BERARDO, LAUREN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BERARDO
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 POPLAR ST # 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1223
Mailing Address - Country:US
Mailing Address - Phone:517-648-5901
Mailing Address - Fax:
Practice Address - Street 1:475 SPRING LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3918
Practice Address - Country:US
Practice Address - Phone:215-482-5353
Practice Address - Fax:215-482-7390
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker