MEDICARE: BLEACH AND ASSOCIATES, LLC

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	101YP2500X	Professional Counselor	LC2131	MD
2	1041C0700X	Clinical Social Worker	11188	MD
3	1041C0700X	Clinical Social Worker	08795	MD
4	2084P0804X	Child & Adolescent Psychiatry Physician	D0027555	MD
5	101YP2500X	Professional Counselor	LC1380	MD
6	101YP2500X	Professional Counselor	LC0357	MD
7	1041C0700X	Clinical Social Worker	03599	MD
8	2084P0800X	Psychiatry Physician	D0037995	MD
9	103TC0700X	Clinical Psychologist	00848	MD

General Provider Information

NPI Number	:	1649254996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLEACH AND ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	9006 WOODYARD RD
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-4206
Country	:	US
Telephone Number	:	301-856-3636
Fax Number	:	301-856-3633

Provider Business Practice Location Address
First Line	:	9006 WOODYARD RD
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-4206
Country	:	US
Telephone Number	:	301-856-3636
Fax Number	:	301-856-3633

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. GAIL BLEACH
Credential	:	PH.D.
Telephone Number	:	301-856-3636

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/02/2008

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Directions to “BLEACH AND ASSOCIATES, LLC ” Practice Location

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