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General NPI Number Information
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NPI Number | 1306700968
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Entity Type | Organization
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Legal Business Name | BRIGHT PATH COUNSELING LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2415 E LOMBARD ST
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City | DAVENPORT
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State | IA
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Zip | 52803-2382
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Country | US
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Telephone | 515-832-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 E LOMBARD ST
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City | DAVENPORT
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State | IA
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Zip | 52803-2382
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Country | US
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Telephone | 515-832-0454
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | PETER ODEGAARD
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Credential | M.A., LMHC, LPC, PAT
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Telephone | 515-832-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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