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General NPI Number Information
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NPI Number | 1629950159
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Entity Type | Organization
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Legal Business Name | A BRIDGE TO HEALING PC
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1625 BETHANY RD
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City | SYCAMORE
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State | IL
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Zip | 60178-3124
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Country | US
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Telephone | 779-777-7335
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10001
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City | LOVES PARK
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State | IL
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Zip | 61131-0001
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Country | US
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Telephone | 779-209-0166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIDGET GARRELTS
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Credential | LCPC
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Telephone | 779-209-0166
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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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