Provider Demographics
NPI:1104597327
Name:COSGROVE, BERNADETTE (LCSW-C)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 E WEST HWY
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4523
Mailing Address - Country:US
Mailing Address - Phone:301-538-5997
Mailing Address - Fax:
Practice Address - Street 1:1000 JEFFERSON ST STE 1B
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-1724
Practice Address - Country:US
Practice Address - Phone:434-771-0495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27729104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker