MEDICARE: ELISHA S BERNSTEIN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	122774	MA

General Provider Information

NPI Number	:	1750608923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISHA S BERNSTEIN LICSW

Provider Business Mailing Address
First Line	:	7 GROVE ST
Second Line	:
City	:	AYER
State	:	MA
Zip	:	01432-1617
Country	:	US
Telephone Number	:	978-985-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 GROVE ST
Second Line	:
City	:	AYER
State	:	MA
Zip	:	01432-1617
Country	:	US
Telephone Number	:	978-985-8655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	09/08/2022

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Directions to “ ELISHA S BERNSTEIN LICSW” Practice Location

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