Healthcare Provider Details

I. General information

NPI: 1063202638
Provider Name (Legal Business Name): BRADLEY JOSEPH ROHRER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11116 MEDICAL CAMPUS RD
HAGERSTOWN MD
21742-6710
US

IV. Provider business mailing address

13107 LITTLE HAYDEN CIR
HAGERSTOWN MD
21742-2539
US

V. Phone/Fax

Practice location:
  • Phone: 240-520-4321
  • Fax: 240-520-4321
Mailing address:
  • Phone: 240-520-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number32615
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32615
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: