Provider Demographics
NPI:1740435932
Name:EPSTEIN, BERNARD L (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:L
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:BERNIE
Other - Middle Name:
Other - Last Name:EPSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1421 AUTUMN RD
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2310
Mailing Address - Country:US
Mailing Address - Phone:610-931-9288
Mailing Address - Fax:267-414-1588
Practice Address - Street 1:1421 AUTUMN RD
Practice Address - Street 2:
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-2310
Practice Address - Country:US
Practice Address - Phone:610-931-9288
Practice Address - Fax:267-414-1588
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0164981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034476500001Medicaid