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NPI Code Detail

MEDICARE: BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER

MEDICARE: BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3103T00000XPsychologist
4104100000XSocial Worker
51041C0700XClinical Social Worker
6163WP0808XPsychiatric/Mental Health Registered Nurse
7251S00000XCommunity/Behavioral Health Agency
8363L00000XNurse Practitioner
9363LP0808XPsychiatric/Mental Health Nurse Practitioner
10261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073561882
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER
Provider Business Mailing Address
First Line : 1320 19TH AVE NW
Second Line :
City : CLINTON
State : IA
Zip : 52732-2752
Country : US
Telephone Number : 563-243-5633
Fax Number : 563-243-9567
Provider Business Practice Location Address
First Line : 1320 19TH AVE NW
Second Line :
City : CLINTON
State : IA
Zip : 52732-2752
Country : US
Telephone Number : 563-243-5633
Fax Number : 563-243-9567
Authorized Official
Title or Position : CONTRACTING & CREDENTIALING COOR
Name : MR. LISA CHRISTOPHER
Credential :
Telephone Number : 563-327-0203
Provider Enumeration Date : 05/04/2006
Last Update Date : 05/01/2025

Similar Medicare Providers

1609823012 — PAUL BLAIR LISW
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567
1003990896 — TINA BUDREAU ARNP
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567
1659400323 — BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567
1205969961 — BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567
1225161987 — BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567
1467639401 — DAVID LOUIS SIEVERS LMHC
Practice Location Address:
1320 19TH AVE NW
CLINTON, IA
52732-2752
Practice Phone: 563-243-5633
Practice Fax: 563-243-9567

Directions to “BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER ” Practice Location

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