Provider Demographics
NPI:1154013134
Name:LERNER&BELEN MSO LLC
Entity type:Organization
Organization Name:LERNER&BELEN MSO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-315-6655
Mailing Address - Street 1:1404 GABLES CT STE 102
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 GABLES CT STE 102
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7647
Practice Address - Country:US
Practice Address - Phone:214-548-4803
Practice Address - Fax:888-974-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty