Provider Demographics
NPI:1881791614
Name:BERRETT, LYNNE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:
Last Name:BERRETT
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 EAST WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3504
Mailing Address - Country:US
Mailing Address - Phone:914-666-0912
Mailing Address - Fax:914-666-2113
Practice Address - Street 1:55 EAST WAY
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3504
Practice Address - Country:US
Practice Address - Phone:914-666-0912
Practice Address - Fax:914-666-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027625-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY711560OtherMVP HEALTH PLANS
NY0005071OtherGHI/EMPIRE PLANS
NYP2753880OtherOXFORD HEALTH PLANS
NY138419OtherVALUE OPTIONS HEALTH PLAN
NY16412OtherUBH HEALTH PLAN
NY711560OtherMVP HEALTH PLANS