Individual provider Active NPI

Bonnie Sheila Eisenberg, CLINICAL PSYCHOLOGIS

  • Clinical Psychologist
  • Chevy Chase, MD
National Provider Identifier
1346264264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00998 Issued in MD
Practice address
3514 Glenmoor Dr
Chevy Chase, MD 20815-5638
Phone
(301) 652-3730
Fax
(301) 652-6658
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00998 MD Primary

Addresses

Primary practice location

3514 Glenmoor Dr
Chevy Chase, MD 20815-5638

Mailing address

3514 Glenmoor Dr
Chevy Chase, MD 20815-5638
Phone (301) 652-3730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346264264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 GLENMOOR DR",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155638",
            "telephone_number": "301-652-3730",
            "fax_number": "301-652-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 GLENMOOR DR",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155638",
            "telephone_number": "301-652-3730",
            "fax_number": "301-652-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "BONNIE",
        "middle_name": "SHEILA",
        "name_prefix": "Dr.",
        "credential": "CLINICAL PSYCHOLOGIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "00998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.