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General NPI Number Information
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NPI Number | 1871056663
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Entity Type | Individual
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Provider Name | BRIDGETTE CALLAGHAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 8310 35TH AVE APT 2D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-5313
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Country | US
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Telephone | 201-452-4983
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 35TH AVE APT 2D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-5313
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Country | US
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Telephone | 201-452-4983
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05689200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 086096
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License Number State | NY
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