Healthcare Provider Details

I. General information

NPI: 1134695257
Provider Name (Legal Business Name): BRIDGET LONGNECKER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9538 PATRICIAN DR
NEW PORT RICHEY FL
34655-5727
US

IV. Provider business mailing address

9538 PATRICIAN DR
NEW PORT RICHEY FL
34655-5727
US

V. Phone/Fax

Practice location:
  • Phone: 727-207-5179
  • Fax:
Mailing address:
  • Phone: 727-207-5179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: