Provider Demographics
NPI:1285903500
Name:BERIONT-VIRGINIA, LYNNE A (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:A
Last Name:BERIONT-VIRGINIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 NEW HOPE ST.
Mailing Address - Street 2:
Mailing Address - City:TUCKERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08087
Mailing Address - Country:US
Mailing Address - Phone:609-276-2316
Mailing Address - Fax:609-276-2316
Practice Address - Street 1:126 N GREEN ST
Practice Address - Street 2:
Practice Address - City:TUCKERTON
Practice Address - State:NJ
Practice Address - Zip Code:08087-2628
Practice Address - Country:US
Practice Address - Phone:609-296-8300
Practice Address - Fax:609-296-0798
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00168100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist