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General NPI Number Information
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NPI Number | 1639208705
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Entity Type | Individual
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Provider Name | BRIDGETTE CHASE LPC, CAC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1005 N GLEBE RD STE 525
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City | ARLINGTON
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State | VA
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Zip | 22201-5792
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Country | US
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Telephone | 804-207-6737
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 IRVING ST NE APT 105
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City | WASHINGTON
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State | DC
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Zip | 20018-2445
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Country | US
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Telephone | 202-635-8078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC 890
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701012647
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License Number State | VA
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