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General NPI Number Information
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NPI Number | 1285769901
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Entity Type | Organization
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Legal Business Name | LERNER COUNSELING AND EDUCATION
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 103 W SENECA ST SUITE 200C
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City | ITHACA
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State | NY
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Zip | 14850-4145
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Country | US
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Telephone | 607-227-3177
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Fax |
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Provider Business Mailing Address
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Address Line | 504 S PLAIN ST
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City | ITHACA
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State | NY
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Zip | 14850-5240
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Country | US
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Telephone | 607-273-1154
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MRS. SUSAN C LERNER
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Credential | LCSW
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Telephone | 607-227-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R019539
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License Number State | NY
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