Healthcare Provider Details

I. General information

NPI: 1457371973
Provider Name (Legal Business Name): BERTA LOWENSTEIN LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3043 STATE ROUTE 4
HUDSON FALLS NY
12839-9632
US

IV. Provider business mailing address

3043 STATE ROUTE 4
HUDSON FALLS NY
12839-9632
US

V. Phone/Fax

Practice location:
  • Phone: 518-747-2284
  • Fax: 518-747-2253
Mailing address:
  • Phone: 518-747-2284
  • Fax: 518-747-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00035212
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier11578810
Identifier TypeOTHER
Identifier State
Identifier IssuerCAQH
# 2
Identifier53088
Identifier TypeOTHER
Identifier State
Identifier IssuerMVP
# 3
Identifier00400166001
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUE SHIELD OF NORTHEASTERN NY
# 4
Identifier00400166001
Identifier TypeOTHER
Identifier State
Identifier IssuerEMPIRE BC/BS
# 5
Identifier00400166001
Identifier TypeOTHER
Identifier State
Identifier IssuerEMPIRE BC/BS BLUE CARD
# 6
Identifier20857
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUE SHIELD
# 7
Identifier00035212
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 8
Identifier00400166001
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARE SENIOR BLUE
# 9
Identifier00400166001
Identifier TypeOTHER
Identifier State
Identifier IssuerHEALTHNOW INTEGRATED
# 10
Identifier040426031838
Identifier TypeOTHER
Identifier State
Identifier IssuerFIDELIS
# 11
IdentifierN9J101
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUECROSS BLUESHIELD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: