MEDICARE: MRS. BRIDGENETT JAMES-BARRIE DSW, MSW, LCSW

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
1	1041C0700X	Clinical Social Worker	SW13321	FL

General Provider Information

NPI Number	:	1134529746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIDGENETT JAMES-BARRIE DSW, MSW, LCSW

Provider Business Mailing Address
First Line	:	3409 PEBBLE SAND LN
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-4228
Country	:	US
Telephone Number	:	850-519-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 PEBBLE SAND LN
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-4228
Country	:	US
Telephone Number	:	850-519-1127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	01/27/2023

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