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General NPI Number Information
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NPI Number | 1285903500
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Entity Type | Individual
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Provider Name | LYNNE A. BERIONT-VIRGINIA LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 126 N GREEN ST
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City | TUCKERTON
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State | NJ
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Zip | 08087-2628
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Country | US
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Telephone | 609-296-8300
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Fax | 609-296-0798
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Provider Business Mailing Address
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Address Line | 136 NEW HOPE ST.
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City | TUCKERTON
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State | NJ
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Zip | 08087
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Country | US
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Telephone | 609-276-2316
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Fax | 609-276-2316
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FI00168100
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License Number State | NJ
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