MEDICARE: BERNADETTE LAMBORNE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC00190600	NJ

General Provider Information

NPI Number	:	1255450938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNADETTE LAMBORNE LCSW

Provider Business Mailing Address
First Line	:	118 OLD COLONY LN
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-1116
Country	:	US
Telephone Number	:	856-854-3155
Fax Number	:	856-854-0992

Provider Business Practice Location Address
First Line	:	215 HIGHLAND AVE
Second Line	:
City	:	HADDON TOWNSHIP
State	:	NJ
Zip	:	08108-2634
Country	:	US
Telephone Number	:	856-854-3155
Fax Number	:	856-983-0496

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	04/17/2014

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