MEDICARE: BRIGHT OUTCOMES SUPPORT SERVICES, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831042852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT OUTCOMES SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	7906 CLOVERTREE CT
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7906 CLOVERTREE CT
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5368
Country	:	US
Telephone Number	:	571-264-8471
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATANYA CRAWFORD
Credential	:
Telephone Number	:	571-264-8471

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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