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General NPI Number Information
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NPI Number | 1104597327
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Entity Type | Individual
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Provider Name | BERNADETTE COSGROVE LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1000 JEFFERSON ST STE 1B
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City | LYNCHBURG
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State | VA
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Zip | 24504-1724
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Country | US
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Telephone | 434-771-0495
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 E WEST HWY
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City | BETHESDA
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State | MD
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Zip | 20814-4523
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Country | US
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Telephone | 301-538-5997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 27729
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27729
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License Number State | MD
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