Provider Demographics
NPI:1134093545
Name:BRIDGE COUNSELING & CONSULTING SERVICES OF KENTUCKY LLC
Entity type:Organization
Organization Name:BRIDGE COUNSELING & CONSULTING SERVICES OF KENTUCKY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-619-7511
Mailing Address - Street 1:718 HAMBRICK AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2339
Mailing Address - Country:US
Mailing Address - Phone:859-398-2830
Mailing Address - Fax:859-545-4910
Practice Address - Street 1:718 HAMBRICK AVE APT 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2339
Practice Address - Country:US
Practice Address - Phone:859-398-2830
Practice Address - Fax:859-545-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty