Provider Demographics
NPI:1982604559
Name:BERNSTEIN, JUDITH R (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:R
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SUBURBAN HOSPITAL COMMUNITY HOMECARE MANAGEMENT PROGRAM
Mailing Address - Street 2:8600 OLD GEORGETOWN ROAD, LAMBERT BLDG. FIRST FLOOR
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-896-6500
Mailing Address - Fax:301-896-6505
Practice Address - Street 1:SUBURBAN HOSPITAL COMMUNITY HOMECARE MANAGEMENT PROGRAM
Practice Address - Street 2:8600 OLD GEORGETOWN ROAD, LAMBERT BLDG. FIRST FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-896-6500
Practice Address - Fax:301-896-6505
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09004104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8405107Medicaid
MD0430-0002OtherBC/BS
MD0430-0002OtherBC/BS