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

Social Worker - Clinical

Active Individual
NPI: 1588816490

Practice Address

5211 AUTH ROAD ST 203
Suitland, MD 20746

Phone: (202) 257-6632

Specialties

Specialty Code Primary License
Counselor - Mental Health 101YM0800X No LC50078990 (DC)
Social Worker 104100000X No -
Social Worker - Clinical 1041C0700X Yes G11619 (MD)
Clinic/Center - Developmental Disabilities 261QD1600X No -

Frequently Asked Questions

NPI 1588816490 is the National Provider Identifier for MR. BRUCE TISDALE, DSW, LICSW, LCSW-C, a Social Worker - Clinical provider located in Suitland, MD. This NPI was enumerated on October 22, 2008.
MR. BRUCE TISDALE, DSW, LICSW, LCSW-C practices at 5211 AUTH ROAD ST 203, Suitland, MD 20746.

Quick Facts

NPI
1588816490
Type
Individual
Enumerated
Oct 22, 2008
Last Updated
Jan 17, 2024

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