Tisdale, Bruce Bernard
Tisdale, Bruce Bernard is an sole proprietor health care provider with primary practice located at 5211 Auth Road St 203 , Suitland MD 20746. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Ambulatory Health Care Facilities / Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Tisdale, Bruce Bernard can be contacted via phone (202) 257-6632.Contact Information
Primary practice address
5211 Auth Road St 203
Suitland MD 20746
Phone: (202) 257-6632
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LC50078990 | District of Columbia |
Behavioral Health & Social Service Providers / Social Worker | 104100000X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC50078990 | Maryland |
Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | G11619 | Maryland |
Profile Details
NPI number | 1588816490 |
---|---|
LBN Legal business name | Tisdale, Bruce Bernard |
Credentials | DSW, LICSW, LCSW-C |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 22nd, 2008 |
Last updated | Jan 17th, 2024 - about 11 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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