Provider Demographics
NPI:1124887047
Name:MEZTLI COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:MEZTLI COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ZAMIR
Authorized Official - Middle Name:O
Authorized Official - Last Name:BRIDGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:917-292-8446
Mailing Address - Street 1:1301 S SCOTT ST APT 329
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-6281
Mailing Address - Country:US
Mailing Address - Phone:917-292-8446
Mailing Address - Fax:
Practice Address - Street 1:1301 S SCOTT ST APT 329
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-6281
Practice Address - Country:US
Practice Address - Phone:917-292-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty