1487785242 NPI number — MR. LOUIS STEVEN BERNS LCSW C

Table of content: MR. LOUIS STEVEN BERNS LCSW C (NPI 1487785242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487785242 NPI number — MR. LOUIS STEVEN BERNS LCSW C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNS
Provider First Name:
LOUIS
Provider Middle Name:
STEVEN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERNS
Provider Other First Name:
L
Provider Other Middle Name:
STEVEN
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487785242
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 1244
Provider Second Line Business Mailing Address:
AVONDALE CENTER
Provider Business Mailing Address City Name:
SOLOMONS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-394-0677
Provider Business Mailing Address Fax Number:
410-394-0677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14350 SOUTH SOLOMONS ISLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOLOMONS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-394-0677
Provider Business Practice Location Address Fax Number:
410-394-0677
Provider Enumeration Date:
03/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  08897 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)