MEDICARE: MS. CHRISTINA MEG 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	CSW003919	GA
2	1041C0700X	Clinical Social Worker	078845-1	NY

General Provider Information

NPI Number	:	1598810921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA MEG BERNSTEIN LCSW

Provider Business Mailing Address
First Line	:	520 W 23RD ST APT 9B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-1135
Country	:	US
Telephone Number	:	917-449-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 CLARKSON AVE RM 4037
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2054
Country	:	US
Telephone Number	:	718-245-2722
Fax Number	:	718-771-3873

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	05/08/2013

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