Bruce Bernard Tisdale, DSW, LICSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

G11619 Issued in MD

Practice address

5211 Auth Road St 203
Suitland, MD 20746

Phone

(202) 257-6632

NPI assigned

Oct 22, 2008

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope 4 You, LLC

  • Clinical Social Worker
  • Suitland, MD
  • NPI 1679948053

  DC

  Medicare reassignment Authorized official
• Kahak, Inc.

  dba Kahak Health Care Services

  • Home Health Agency
  • Washington, DC
  • NPI 1568638187

  Clinical

  Medicare reassignment NPD
• The Family Wellness Center, Inc

  • Community/Behavioral Health Agency
  • Washington, DC
  • NPI 1609141704
  Medicare reassignment NPD
• Hope 4 You, LLC

  • Clinical Social Worker
  • Suitland, MD
  • NPI 1770104291
  NPD Authorized official
• Hope 4 You, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Suitland, MD
  • NPI 1144903105
  Authorized official Same address or phone
• The Family Wellness Center, Inc

  • Case Management Agency
  • Washington, DC
  • NPI 1437534740
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1588816490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 MCINTOSH PL",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206137795",
            "telephone_number": "202-257-6632",
            "fax_number": "202-257-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 AUTH ROAD ST 203",
            "city": "SUITLAND",
            "state": "MD",
            "postal_code": "20746",
            "telephone_number": "202-257-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "BRUCE",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "credential": "DSW, LICSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2026-09-29",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "LC50078990",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "LC50078990",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "G11619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laverne Thomas, RDH
• Rhonda L Thomas, LCSW
• Staci Thompson
• Trashawn Nicole Thornton Davis, MD
• Tara Alison Tibbs, LMSW
• Toria , LLC (dba Griswol Home Care)
• Total Health, LLC
• Transformations, LLC
• Transformations, LLC
• Robert Troise, D.D.S

• Clinical Social Worker in Suitland, MD
• Providers in Suitland, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.