MEDICARE: BRIDGET MACDONALD LICSW

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	LC200002889	DC

General Provider Information

NPI Number	:	1083449920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET MACDONALD LICSW

Provider Business Mailing Address
First Line	:	922 3RD ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209A N EAST ST STE 106
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4624
Country	:	US
Telephone Number	:	240-788-2328
Fax Number	:

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

Provider Enumeration Date	:	09/02/2024
Last Update Date	:	02/09/2026

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