MEDICARE: ALEJANDRO BERTHE-SUAREZ MSW, LCSW-C

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	18827	MD
2	1041C0700X	Clinical Social Worker	0904009110	VA

General Provider Information

NPI Number	:	1194182212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO BERTHE-SUAREZ MSW, LCSW-C

Provider Business Mailing Address
First Line	:	8421 BROAD ST
Second Line	:	UNIT 1109
City	:	MC LEAN
State	:	VA
Zip	:	22102-3704
Country	:	US
Telephone Number	:	301-377-2671
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 WISCONSIN AVE
Second Line	:	700
City	:	BETHESDA
State	:	MD
Zip	:	20814-4810
Country	:	US
Telephone Number	:	301-654-7770
Fax Number	:

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

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	01/20/2016

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