Provider Demographics
NPI:1447080551
Name:LERNER PSYCHOLOGICAL SERVICES, PC
Entity type:Organization
Organization Name:LERNER PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-385-7551
Mailing Address - Street 1:150 BROADHOLLOW RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4901
Mailing Address - Country:US
Mailing Address - Phone:631-385-7551
Mailing Address - Fax:
Practice Address - Street 1:150 BROADHOLLOW RD STE 102
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4901
Practice Address - Country:US
Practice Address - Phone:631-385-7551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty