Healthcare Provider Details

I. General information

NPI: 1427660935
Provider Name (Legal Business Name): BOBBY KEARSE LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15000 BROSCHART RD
ROCKVILLE MD
20850-3303
US

IV. Provider business mailing address

11428 APPLEDOWRE WAY
GERMANTOWN MD
20876-5505
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-6800
  • Fax: 301-560-5558
Mailing address:
  • Phone: 240-630-1795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: