Provider Demographics
NPI:1245813351
Name:LERNER, BETH (MED, MSW, LCSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:LERNER
Suffix:
Gender:F
Credentials:MED, MSW, LCSW
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:563 PATTEN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-7823
Mailing Address - Country:US
Mailing Address - Phone:732-977-4987
Mailing Address - Fax:
Practice Address - Street 1:421 FOREST ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2335
Practice Address - Country:US
Practice Address - Phone:781-834-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL065718001041C0700X
MA0002268031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical