Provider Demographics
NPI:1285775247
Name:BRIDGES, SUSAN MELINDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MELINDA
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 WINDSOR DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18195-1015
Mailing Address - Country:US
Mailing Address - Phone:610-398-1294
Mailing Address - Fax:610-965-8902
Practice Address - Street 1:7540 WINDSOR DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18195-1015
Practice Address - Country:US
Practice Address - Phone:610-398-1294
Practice Address - Fax:610-965-8902
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008703L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health