Healthcare Provider Details

I. General information

NPI: 1386467207
Provider Name (Legal Business Name): ALYSSA KERBER MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 LITTLE BRITAIN RD
ROCK TAVERN NY
12575-5254
US

IV. Provider business mailing address

1661 LITTLE BRITAIN RD
ROCK TAVERN NY
12575-5254
US

V. Phone/Fax

Practice location:
  • Phone: 845-633-9648
  • Fax:
Mailing address:
  • Phone: 845-633-9648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number002371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: