Provider Demographics
NPI:1306645874
Name:STUCHLY, BRIDGET MARIE (CSW)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MARIE
Last Name:STUCHLY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 S DENVER ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CTY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1511
Mailing Address - Country:US
Mailing Address - Phone:801-243-2744
Mailing Address - Fax:
Practice Address - Street 1:4376 S 700 E STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3077
Practice Address - Country:US
Practice Address - Phone:385-272-4292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13991818-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical