Healthcare Provider Details

I. General information

NPI: 1770422545
Provider Name (Legal Business Name): BRIDGEWAY INTEGRATED HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 OAK MEADOW DR
FRANKLIN TN
37064-5504
US

IV. Provider business mailing address

810 OAK MEADOW DR
FRANKLIN TN
37064-5504
US

V. Phone/Fax

Practice location:
  • Phone: 801-383-2069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: NATALIE WHATCOTT
Title or Position: CEO
Credential:
Phone: 801-255-5131