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General NPI Number Information
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NPI Number | 1629450283
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Entity Type | Organization
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Legal Business Name | BRIDGE COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 332 W BROADWAY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40202-2115
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Country | US
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Telephone | 502-553-0741
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Fax |
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Provider Business Mailing Address
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Address Line | 332 W BROADWAY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40202-2115
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Country | US
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Telephone | 502-553-0741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE SARTINI
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Credential | LPPC
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Telephone | 502-553-0741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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