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General NPI Number Information
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NPI Number | 1376938779
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Entity Type | Organization
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Legal Business Name | NEW BRIDGE COUNSELING SERVICES
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 2377 GOLD MEADOW WAY, SUITE 100
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City | GOLD RIVER
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State | CA
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Zip | 95670
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Country | US
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Telephone | 916-729-3242
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Fax |
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Provider Business Mailing Address
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Address Line | 2377 GOLD MEADOW WAY, SUITE 100
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City | GOLD RIVER
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State | CA
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Zip | 95670
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Country | US
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Telephone | 916-729-3242
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Fax | 916-631-1573
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Authorized Official
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Title or Position | OWNER
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Name | MS. LESLIE A. HAWS
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Credential | MA, LMFT, CSAT
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Telephone | 916-729-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 36717
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License Number State | CA
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