Provider Demographics
NPI:1194064394
Name:BRIDGES, CALEB JOSIAH (LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:CALEB
Middle Name:JOSIAH
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4110
Mailing Address - Country:US
Mailing Address - Phone:228-297-5883
Mailing Address - Fax:
Practice Address - Street 1:808 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4110
Practice Address - Country:US
Practice Address - Phone:404-832-5870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2248101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health