MEDICARE: HELEN SUSAN BERNSTEIN LICENSED CLINICAL SO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149001956	IL
2	1041C0700X	Clinical Social Worker	LCSW-15307	AZ

General Provider Information

NPI Number	:	1023164183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN SUSAN BERNSTEIN LICENSED CLINICAL SO

Provider Business Mailing Address
First Line	:	4980 S ALMA SCHOOL RD
Second Line	:	SUITE 2, #308
City	:	CHANDLER
State	:	AZ
Zip	:	85248-5545
Country	:	US
Telephone Number	:	312-593-4456
Fax Number	:	480-639-1349

Provider Business Practice Location Address
First Line	:	3200 N DOBSON RD
Second Line	:	BUILDING C, SUITE 109
City	:	CHANDLER
State	:	AZ
Zip	:	85224-9601
Country	:	US
Telephone Number	:	312-593-4456
Fax Number	:	480-639-1349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	01/29/2015

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