Provider Demographics
NPI:1871651885
Name:BERNES, JUDITH ROSE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ROSE
Last Name:BERNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 PARROTT ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1020
Mailing Address - Country:US
Mailing Address - Phone:845-634-3468
Mailing Address - Fax:845-634-3468
Practice Address - Street 1:175 PARROTT ROAD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-1020
Practice Address - Country:US
Practice Address - Phone:845-634-3468
Practice Address - Fax:845-634-3468
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0149861104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
56233OtherVBS
P1889766OtherROCKLAND OXFORD
10766770OtherCOQH
374175OtherPHCS
NYP2801812OtherOXFORD
74940044OtherGHI
108333OtherMHN
109560OtherMAGELLAN BEHAVIORAL HEALT
118055OtherVALUE OPTIONS
10766770OtherCOQH