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General NPI Number Information
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NPI Number | 1710043195
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Entity Type | Individual
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Provider Name | MADALINE BERLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 155 EAST 55TH ST NE SUITE 5J
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City | NEW YORK
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State | NY
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Zip | 10022-4038
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Country | US
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Telephone | 212-759-4245
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Fax | 212-988-3906
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Provider Business Mailing Address
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Address Line | 155 EAST 55TH ST NE SUITE 5J
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City | NEW YORK
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State | NY
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Zip | 10022-4038
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Country | US
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Telephone | 212-759-4245
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Fax | 212-759-9908
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | R032852
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License Number State | NY
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