MEDICARE: JODI BRIGHT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	5351-125	WI

General Provider Information

NPI Number	:	1528319985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI BRIGHT LPC

Provider Business Mailing Address
First Line	:	11314 200TH ST
Second Line	:
City	:	JIM FALLS
State	:	WI
Zip	:	54748-1708
Country	:	US
Telephone Number	:	715-864-1187
Fax Number	:

Provider Business Practice Location Address
First Line	:	4330 GOLF TER STE 205C
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-4688
Country	:	US
Telephone Number	:	715-598-1563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	07/27/2022

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