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General NPI Number Information
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NPI Number | 1134093545
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Entity Type | Organization
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Legal Business Name | BRIDGE COUNSELING & CONSULTING SERVICES OF KENTUCKY LLC
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 718 HAMBRICK AVE APT 1
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City | LEXINGTON
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State | KY
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Zip | 40508-2339
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Country | US
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Telephone | 859-398-2830
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Fax | 859-545-4910
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Provider Business Mailing Address
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Address Line | 718 HAMBRICK AVE APT 1
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City | LEXINGTON
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State | KY
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Zip | 40508-2339
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Country | US
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Telephone | 859-398-2830
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Fax | 859-545-4910
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | MR. DANIEL M BEASLEY
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Credential | LCSW
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Telephone | 859-619-7511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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