Provider Demographics
NPI:1225198278
Name:BRIDGES, ALICIA MONIQUE (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MONIQUE
Last Name:BRIDGES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MONIQUE
Other - Last Name:COLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:125 RESHA RD
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-8440
Mailing Address - Country:US
Mailing Address - Phone:225-975-1571
Mailing Address - Fax:
Practice Address - Street 1:1602 W PINHOOK RD STE 102
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3735
Practice Address - Country:US
Practice Address - Phone:337-282-7978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA51751041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker