Provider Demographics
NPI:1194182212
Name:BERTHE-SUAREZ, ALEJANDRO (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:BERTHE-SUAREZ
Suffix:
Gender:M
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 BROAD ST
Mailing Address - Street 2:UNIT 1109
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3704
Mailing Address - Country:US
Mailing Address - Phone:301-377-2671
Mailing Address - Fax:
Practice Address - Street 1:7201 WISCONSIN AVE
Practice Address - Street 2:700
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4810
Practice Address - Country:US
Practice Address - Phone:301-654-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD188271041C0700X
VA09040091101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical