Provider Demographics
NPI:1104844232
Name:BERNSTEIN, EILEEN P (NCSC, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:P
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:NCSC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 HENSLOWE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6178
Mailing Address - Country:US
Mailing Address - Phone:301-762-6687
Mailing Address - Fax:
Practice Address - Street 1:2418 HENSLOWE DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-6178
Practice Address - Country:US
Practice Address - Phone:301-762-6687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCO149101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool