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General NPI Number Information
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NPI Number | 1467258152
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Entity Type | Organization
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Legal Business Name | BLUE BRIDGE THERAPY MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 912 W CABARRUS ST
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City | RALEIGH
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State | NC
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Zip | 27603-1902
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Country | US
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Telephone | 646-535-9803
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Fax |
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Provider Business Mailing Address
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Address Line | 348 4TH AVE # 1050
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City | BROOKLYN
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State | NY
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Zip | 11215-2718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. NICOLE CUTTITA
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Credential | LMHC
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Telephone | 646-535-9803
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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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