Doctor Name: | MS. LORI EILEEN BERTANZETTI |
NPI Number: | 1629292008 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 44SL05367800 |
Business Practice Address: | 1385 Pocono Blvd Mount Pocono, PA - 183441678 |
Business Phone Number: | 5704604379 |
Business Fax Number: | 5704213600 |
Mailing Address: | 332 Henrys Crossing Rd, CRESCO |
State: | PA |
Postal Code: | 183267748 |
Phone Number: | 5704604379 |
Fax Number: | 5704213600 |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 10/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SL05367800 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |