Healthcare Provider Details

I. General information

NPI: 1730007592
Provider Name (Legal Business Name): HEATH JORDAN BRIGHTMAN LMHC, LPC, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 WOODMARK WAY
SOUTH KINGSTOWN RI
02879-7678
US

IV. Provider business mailing address

61 WOODMARK WAY
SOUTH KINGSTOWN RI
02879-7678
US

V. Phone/Fax

Practice location:
  • Phone: 973-632-5248
  • Fax:
Mailing address:
  • Phone: 401-485-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2026-0648
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0024258
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC02032
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMI-0000465
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5859
License Number StateNH
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0137278TELE
License Number StateVT
# 7
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4581626
License Number StateID
# 8
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberTPMC8058
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2607335
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103201
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: