Provider Demographics
NPI:1396881371
Name:BERNABE, LAURA M (LMHC,CASAC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:BERNABE
Suffix:
Gender:F
Credentials:LMHC,CASAC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:DOGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CASAC
Mailing Address - Street 1:2345 ROUTE 52
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3218
Mailing Address - Country:US
Mailing Address - Phone:845-206-6512
Mailing Address - Fax:888-972-5017
Practice Address - Street 1:2345 ROUTE 52
Practice Address - Street 2:SUITE F
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3218
Practice Address - Country:US
Practice Address - Phone:845-206-6512
Practice Address - Fax:888-972-5017
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12927101YA0400X
NY000535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12927OtherCREDENTIAL NUMBER
NY000535OtherLICENSE NUMBER