Bruce Bernard Tisdale, DSW, LICSW, LCSW-C
NPI 1588816490ActiveIndividual· Social Worker, Clinical· Suitland, MD
Social Worker, Clinical (DSW, LICSW, LCSW-C) in Suitland, Maryland, licensed in MD and DC, with an NPI issued in October 2008. Medicare paid $50,051 for services to 25 patients in 2024.
Overview
| NPI | 1588816490 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DSW, LICSW, LCSW-C |
| Sole proprietor | Yes |
| NPI issued | Oct 22, 2008 |
| Last updated in NPPES | Sep 29, 2026 |
| Certified by provider | Jan 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | G11619 | MD |
| Counselor, Mental Health | 101YM0800X | LC50078990 | DC |
| Social Worker | 104100000X | — | — |
| Social Worker, Clinical | 1041C0700X | LC50078990 | MD |
| Clinic/Center, Developmental Disabilities | 261QD1600X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (DC) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 25 |
|---|---|
| Services billed | 588 across 2 procedure codes |
| Paid by Medicare | $50,051 |
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
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All 16 clinical social workers in Suitland · All clinical social workers in Maryland