Provider Demographics
NPI:1982035903
Name:BERNSTEIN, LISA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15724 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2656
Mailing Address - Country:US
Mailing Address - Phone:301-590-0115
Mailing Address - Fax:
Practice Address - Street 1:15724 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2656
Practice Address - Country:US
Practice Address - Phone:301-590-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-01
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical