Provider Demographics
NPI:1205170495
Name:LERNER, LAWRENCE
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 FENN ST
Mailing Address - Street 2:ADMINISTRATIVE OFFICES
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5261
Mailing Address - Country:US
Mailing Address - Phone:413-629-1262
Mailing Address - Fax:413-448-2198
Practice Address - Street 1:359 FENN ST
Practice Address - Street 2:ADMINISTRATIVE OFFICES
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5261
Practice Address - Country:US
Practice Address - Phone:413-629-1262
Practice Address - Fax:413-448-2198
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)