Provider Demographics
NPI:1720299548
Name:BERNTHAL, JOAN MARX (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARX
Last Name:BERNTHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8901 PERSIMMON TREE RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4319
Mailing Address - Country:US
Mailing Address - Phone:301-365-8875
Mailing Address - Fax:301-365-7300
Practice Address - Street 1:5217 WISCONSIN AVE NW
Practice Address - Street 2:#207
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2075
Practice Address - Country:US
Practice Address - Phone:202-244-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3002651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical