Healthcare Provider Details

I. General information

NPI: 1356592059
Provider Name (Legal Business Name): BRIDGEPOINTE PSYCHOLOGICAL & COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 WELLINGTON PL
CINCINNATI OH
45219-1710
US

IV. Provider business mailing address

4240 HUNT RD
CINCINNATI OH
45242-6612
US

V. Phone/Fax

Practice location:
  • Phone: 513-891-0650
  • Fax: 513-891-2838
Mailing address:
  • Phone: 513-891-0650
  • Fax: 513-891-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: NANCY STELLA
Title or Position: PRESIDENT
Credential: PHD, PSYD
Phone: 513-891-0650