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General NPI Number Information
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NPI Number | 1720525413
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Entity Type | Organization
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Legal Business Name | BRIDGEWAY COUNSELING
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 05/07/2023
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Provider Practice Location Address
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Address Line | 22 SOUTH MAIN ST SUITE 303
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City | WOLFEBORO
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State | NH
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Zip | 03894-3848
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Country | US
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Telephone | 603-834-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 284 CENTER ST
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City | WOLFEBORO
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State | NH
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Zip | 03894
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Country | US
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Telephone | 603-834-9944
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH MICHAEL BROWN
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Credential | MS, LCMHC
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Telephone | 603-834-9944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NH
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Taxonomy #2
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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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