MEDICARE: COVERED BRIDGE COUNSELING, LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1285586859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVERED BRIDGE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	140 N MADISON AVE # 335
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9998
Country	:	US
Telephone Number	:	502-771-2787
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 N MADISON AVE # 335
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9998
Country	:	US
Telephone Number	:	502-771-2787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HEIDE FORRISTER
Credential	:	MA, LPCC
Telephone Number	:	502-771-2787

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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