Provider Demographics
NPI:1386409837
Name:BERNSTEIN, LIORA E
Entity type:Individual
Prefix:
First Name:LIORA
Middle Name:E
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 OVERLAND AVE APT H172
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6374
Mailing Address - Country:US
Mailing Address - Phone:561-702-2991
Mailing Address - Fax:
Practice Address - Street 1:333 NAHANTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3213
Practice Address - Country:US
Practice Address - Phone:720-835-2937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2298951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical