Provider Demographics
NPI:1649988213
Name:BERNS, AMY MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:BERNS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2119
Mailing Address - Country:US
Mailing Address - Phone:757-903-5271
Mailing Address - Fax:
Practice Address - Street 1:9070 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1825
Practice Address - Country:US
Practice Address - Phone:716-632-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33004391A104100000X
KY256113104100000X
NY1425679104100000X
VA09040106161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical