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General NPI Number Information
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NPI Number | 1265337315
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Entity Type | Organization
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Legal Business Name | MINDBRIDGE THERAPY, LLC
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 126 MARKET WAY # 18344
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City | MOUNT POCONO
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State | PA
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Zip | 18344-1039
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Country | US
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Telephone | 570-807-6226
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Fax |
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Provider Business Mailing Address
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Address Line | 126 MARKET WAY # 18344
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City | MOUNT POCONO
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State | PA
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Zip | 18344-1039
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Country | US
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Telephone | 570-807-6226
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | LOUISE EVANGELINE KNIGHT-LONG
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Credential |
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Telephone | 570-807-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NULL
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