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MR. BRUCE BERNARD TISDALE DSW, LICSW, LCSW-C
NPI 1588816490
Social Worker - Clinical in Suitland, MD

Active since October 22, 2008PECOS EnrolledAccepts Medicare Assignment
5211 AUTH ROAD ST 203, SUITLAND, MD 20746(202) 257-6632 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 4, 2024, Dec 12, 2023, Nov 1, 2023 and 3 more (6 updates tracked since 2016).

About Mr. Bruce Bernard Tisdale Dsw, Licsw, Lcsw-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRUCE BERNARD TISDALE DSW, LICSW, LCSW-C (NPI 1588816490) is an individual clinical provider in Suitland, Maryland, licensed in Maryland (G11619) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1588816490
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. BRUCE BERNARD TISDALECredential: DSW, LICSW, LCSW-C
Location Address5211 AUTH ROAD ST 203Suitland, MD 20746
Mailing Address5805 Mcintosh PlBrandywine, MD 20613-7795 · (202) 257-6632 · Fax (202) 257-6632
Phone(202) 257-6632
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateOctober 22, 2008
Last NPPES UpdateJanuary 17, 20246 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2024
✔ NPI 1588816490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MD · G11619✔ Licensed in MD · LC50078990
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LC50078990 (DC)
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedClinic/Center · Developmental DisabilitiesTaxonomy 261QD1600X
5211 AUTH ROAD ST 203, Suitland, MD 20746
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Bruce Bernard Tisdale Dsw, Licsw, Lcsw-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315104965
PECOS Enrollment IDI20120209000108
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
578 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20746 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $65.18 – $194.86
Typical copayment $0.00 (range $16.29 – $48.71)
Most-billed visit code NA
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOPE 4 YOU, LLC
Social Worker (Clinical)
5211 AUTH ROAD ST 203
SUITLAND, MD 20746
Prince George's County (202) 257-6632

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Tisdale's NPI number?

The NPI number for Bruce Tisdale is 1588816490. It was assigned to this individual provider in the NPPES registry on October 22, 2008.

Where is Bruce Tisdale located?

Bruce Tisdale practices at 5211 Auth Road St 203, Suitland, MD 20746. The listed phone number is (202) 257-6632.

What is Bruce Tisdale's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Bruce Tisdale enrolled in Medicare?

Yes. Bruce Tisdale is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Bruce Tisdale was last updated on January 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.