Healthcare Provider Details

I. General information

NPI: 1396881371
Provider Name (Legal Business Name): LAURA M BERNABE LMHC,CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA M DOGAS MS,CASAC

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 ROUTE 52 SUITE F
HOPEWELL JUNCTION NY
12533-3218
US

IV. Provider business mailing address

2345 ROUTE 52 SUITE F
HOPEWELL JUNCTION NY
12533-3218
US

V. Phone/Fax

Practice location:
  • Phone: 845-206-6512
  • Fax: 888-972-5017
Mailing address:
  • Phone: 845-206-6512
  • Fax: 888-972-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12927
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000535
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: