Provider Demographics
NPI:1255450938
Name:LAMBORNE, BERNADETTE (LCSW)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:LAMBORNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:B. FRANKIE
Other - Middle Name:
Other - Last Name:LAMBORNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:118 OLD COLONY LN
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1116
Mailing Address - Country:US
Mailing Address - Phone:856-854-3155
Mailing Address - Fax:856-854-0992
Practice Address - Street 1:215 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2634
Practice Address - Country:US
Practice Address - Phone:856-854-3155
Practice Address - Fax:856-983-0496
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001906001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJLA745570Medicare ID - Type Unspecified