NPIMap

Organization Active NPI

Elise Bershaw, LCSW-C

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1598201600
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12123 Issued in MD
Legal business name
ELISE BERSHAW, LCSW-C
Practice address
10 W Madison St
Lower Level
Baltimore, MD 21201-5239
Phone
(410) 212-9463
NPI assigned
Jan 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Ms. Elise Wendy Bershaw, LCSW-C
Title
Psychotherapist
Phone
(410) 212-9463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 12123 MD Primary

Addresses

Primary practice location

10 W Madison St
Lower Level
Baltimore, MD 21201-5239

Mailing address

PO Box 67149
Baltimore, MD 21215
Phone (410) 212-9463

Other identifiers 1

IdentifierTypeStateIssuer
1932331139OtherMDSOLO NPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1598201600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67149",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-212-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W MADISON ST",
            "address_2": "LOWER LEVEL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015239",
            "telephone_number": "410-212-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISE BERSHAW, LCSW-C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "BERSHAW",
        "authorized_official_first_name": "ELISE",
        "authorized_official_middle_name": "WENDY",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "410-212-9463",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "12123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLO NPI",
            "identifier": "1932331139",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.