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General NPI Number Information
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NPI Number | 1669452868
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Entity Type | Individual
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Provider Name | BRUCINDA LOUISE BEACH LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVENUE BEHAVIRORAL HEALTHCARE CLINIC, BLDG. 7, 3RD FLOOR
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 7205 45TH ST
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6032
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Country | US
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Telephone | 301-656-3520
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 03162
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License Number State | MD
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