Doctor Name: | MS. COLETTE A. KERN |
NPI Number: | 1053435529 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L-MSW |
License Number: | RO30202-1 |
Business Practice Address: | 222 Manor Pl Greenport, NY - 119441261 |
Business Phone Number: | 6312988642 |
Business Fax Number: | |
Mailing Address: | 222 Manor Place, GREENPORT |
State: | NY |
Postal Code: | 11944 |
Phone Number: | 6312988642 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | RO30202-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |