| Lisa H. Kornberg, Llc | |
|
5901 Falls Rd Baltimore MD 21209-3725 | |
| (113) 590-3701 | |
| (844) 917-2824 |
| Full Name | Lisa H. Kornberg, Llc |
|---|---|
| Speciality | Counselor |
| Location | 5901 Falls Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Lisa Harriet Kornberg (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4435903701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa H. Kornberg, Llc 5901 Falls Rd Baltimore MD 21209-3725 Ph: (443) 590-3701 | Lisa H. Kornberg, Llc 5901 Falls Rd Baltimore MD 21209-3725 Ph: (113) 590-3701 |
| NPI Number | 1811762891 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 7315396116 |
|---|---|
| Medicare Enrollment ID | O20231205002551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811762891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lisa Harriet Kornberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477564805 PECOS PAC ID: 4688754997 Enrollment ID: I20231205002648 |
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