Provider Demographics
NPI:1386116275
Name:BRIDGERLAND COUNSELING
Entity type:Organization
Organization Name:BRIDGERLAND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:435-512-7759
Mailing Address - Street 1:3522 W 1450 N
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:UT
Mailing Address - Zip Code:84015-7337
Mailing Address - Country:US
Mailing Address - Phone:435-512-7759
Mailing Address - Fax:
Practice Address - Street 1:3522 W 1450 N
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:UT
Practice Address - Zip Code:84015-7337
Practice Address - Country:US
Practice Address - Phone:435-512-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)