1679916803 NPI number — BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION

Table of content: MRS. JODIE BETH LERNER LMHC (NPI 1487797429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679916803 NPI number — BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679916803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
592 ROCKAWAY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11212-5539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-435-5000
Provider Business Mailing Address Fax Number:
718-345-5794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 HINSDALE ST
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11207-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-505-0801
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LAWRENCE
Authorized Official First Name:
HARVEY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
718-345-5000

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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