Provider Demographics
NPI:1891910576
Name:LERNER, JOAN D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:D
Last Name:LERNER
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 1:498 MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2208
Mailing Address - Country:US
Mailing Address - Phone:845-268-3812
Mailing Address - Fax:845-268-3812
Practice Address - Street 1:498 MITCHELL DR
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2208
Practice Address - Country:US
Practice Address - Phone:845-268-3812
Practice Address - Fax:845-268-3812
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0195381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN11121Medicare ID - Type Unspecified