Provider Demographics
NPI:1780875732
Name:LERNER, JONATHAN A (PHD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:LERNER
Suffix:
Gender:M
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:1 BOWDOIN SQ STE 700
Mailing Address - Street 2:MGH - DEPT OF PSYCHIATRY - BEHAVIORAL MEDICINE (BS07B)
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2932
Mailing Address - Country:US
Mailing Address - Phone:617-726-3423
Mailing Address - Fax:
Practice Address - Street 1:1 BOWDOIN SQ STE 700
Practice Address - Street 2:MGH - DEPT OF PSYCHIATRY - BEHAVIORAL MEDICINE (BS07B)
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2932
Practice Address - Country:US
Practice Address - Phone:617-726-3423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA9264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical