Healthcare Provider Details

I. General information

NPI: 1740435932
Provider Name (Legal Business Name): BERNARD L EPSTEIN MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BERNIE EPSTEIN

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 AUTUMN RD
RYDAL PA
19046-2310
US

IV. Provider business mailing address

1421 AUTUMN RD
RYDAL PA
19046-2310
US

V. Phone/Fax

Practice location:
  • Phone: 610-931-9288
  • Fax: 267-414-1588
Mailing address:
  • Phone: 610-931-9288
  • Fax: 267-414-1588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016498
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1034476500001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: