MEDICARE: SANDRA BERNSTEIN LCSW

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	SW 7980	FL

General Provider Information

NPI Number	:	1174717144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BERNSTEIN LCSW

Provider Business Mailing Address
First Line	:	5415 NW 122ND DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3639
Country	:	US
Telephone Number	:	954-471-8279
Fax Number	:

Provider Business Practice Location Address
First Line	:	7501 WILES RD
Second Line	:	SUITE 102B
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2063
Country	:	US
Telephone Number	:	954-471-8279
Fax Number	:	561-734-8351

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

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	11/17/2011

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Directions to “ SANDRA BERNSTEIN LCSW” Practice Location

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