=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730007592
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEATH JORDAN BRIGHTMAN LMHC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2026
-----------------------------------------------------
Last Update Date | 07/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 61 WOODMARK WAY
-----------------------------------------------------
City | SOUTH KINGSTOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02879-7678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-632-5248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 61 WOODMARK WAY
-----------------------------------------------------
City | SOUTH KINGSTOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02879-7678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-632-5248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MHC02032
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 068.0137278TELE
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | TPMC8058
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | E.2607335
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------