MEDICARE: BRIDGEWOOD 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1609704675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGEWOOD COUNSELING LLC

Provider Business Mailing Address
First Line	:	6316 WALKER AVE
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-4212
Country	:	US
Telephone Number	:	815-315-7611
Fax Number	:

Provider Business Practice Location Address
First Line	:	7124 WINDSOR LAKE PKWY
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-3800
Country	:	US
Telephone Number	:	815-315-7611
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	APRIL LIPNITZKY
Credential	:	LCSW
Telephone Number	:	815-315-7611

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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