Provider Demographics
NPI:1285769901
Name:LERNER COUNSELING AND EDUCATION
Entity type:Organization
Organization Name:LERNER COUNSELING AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:607-227-3177
Mailing Address - Street 1:504 S PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5240
Mailing Address - Country:US
Mailing Address - Phone:607-273-1154
Mailing Address - Fax:
Practice Address - Street 1:103 W SENECA ST
Practice Address - Street 2:SUITE 200C
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4145
Practice Address - Country:US
Practice Address - Phone:607-227-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0195391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0486Medicare PIN