Healthcare Provider Details

I. General information

NPI: 1982604559
Provider Name (Legal Business Name): JUDITH R BERNSTEIN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUBURBAN HOSPITAL COMMUNITY HOMECARE MANAGEMENT PROGRAM 8600 OLD GEORGETOWN ROAD, LAMBERT BLDG. FIRST FLOOR
BETHESDA MD
20814
US

IV. Provider business mailing address

SUBURBAN HOSPITAL COMMUNITY HOMECARE MANAGEMENT PROGRAM 8600 OLD GEORGETOWN ROAD, LAMBERT BLDG. FIRST FLOOR
BETHESDA MD
20814
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-6500
  • Fax: 301-896-6505
Mailing address:
  • Phone: 301-896-6500
  • Fax: 301-896-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number09004
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: