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General NPI Number Information
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NPI Number | 1578015673
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Entity Type | Individual
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Provider Name | CARLA LYNN BERNSTEIN PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 1225 MORRIS PARK AVE
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City | BRONX
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State | NY
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Zip | 10461-1929
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Country | US
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Telephone | 718-430-3907
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Fax | 718-904-1162
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Provider Business Mailing Address
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Address Line | 200 N 16TH ST PH 22
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1225
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Country | US
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Telephone | 315-391-9056
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 022735
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS019647
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License Number State | PA
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