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General NPI Number Information
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NPI Number | 1407161821
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Entity Type | Individual
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Provider Name | LYNDA MARIE BERA LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 280 BROADWAY LOWER LEVEL
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City | NEWBURGH
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State | NY
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Zip | 12550-5408
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Country | US
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Telephone | 845-562-8255
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Fax | 845-562-4140
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Provider Business Mailing Address
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Address Line | 633 GIDNEY AVE STE 6
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City | NEWBURGH
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State | NY
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Zip | 12550-2805
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Country | US
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Telephone | 845-569-2900
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Fax | 866-619-5710
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082816-1
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License Number State | NY
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