Provider Demographics
NPI:1194943928
Name:BERNARDI, JUDITH M (LCSW,PHD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:BERNARDI
Suffix:
Gender:F
Credentials:LCSW,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 2ND AVE
Mailing Address - Street 2:#503
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3355
Mailing Address - Country:US
Mailing Address - Phone:301-587-8856
Mailing Address - Fax:
Practice Address - Street 1:8607 2ND AVE
Practice Address - Street 2:#503
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3355
Practice Address - Country:US
Practice Address - Phone:301-587-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical