Provider Demographics
NPI:1225861552
Name:BRIGHTPATH EVALUATION SERVICES, LLP
Entity type:Organization
Organization Name:BRIGHTPATH EVALUATION SERVICES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-300-2464
Mailing Address - Street 1:1628 CHEESEHOUSE RD SW
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43837-9000
Mailing Address - Country:US
Mailing Address - Phone:843-300-2464
Mailing Address - Fax:
Practice Address - Street 1:610 COMMERCIAL AVE SW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-9365
Practice Address - Country:US
Practice Address - Phone:330-663-1294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty