DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. BRUCE BERNARD TISDALE, DSW, LICSW, LCSW-C

Active Sole Proprietor

MR. BRUCE BERNARD TISDALE, DSW, LICSW, LCSW-C is a Clinical Social Worker healthcare provider located in SUITLAND, Maryland. NPI 1588816490 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · SUITLAND, MD

Registration Details

NPI Number
1588816490
Provider Type
Individual
Gender
Male
NPI Issued
Oct 22, 2008 (17.777242293137 yrs)
Last Updated
Jan 17, 2024
Licenses
LC50078990 (DC)
LC50078990 (MD)
G11619 (MD)
Sole Proprietor
Yes

Practice Information

Address
5211 AUTH ROAD ST 203
SUITLAND, MD, 20746
Browse MD providers · Browse ZIP 20746
Phone
2022576632
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Social Worker
Additional Specialty
Clinical Social Worker
Additional Specialty
Clinical Social Worker

Other Clinical Social Worker Providers in SUITLAND, MD

Name Credential NPI
MS. DAWN M ANDERSON LCSW-C 1184643918
MS. BENILDA N SHAHEED LCSW-C, LICSW 1609944032
MRS. LORETTA DOLORES PETERSON MSW 1649309857
MRS. CHRISTINE DAWKINS-BREWSTER LICSW, LCSW-C, LISW 1235357278
RHONDA L THOMAS LCSW 1902008303
LEEANNA A. BELTON LICSW 1609069426
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.