Provider Demographics
NPI:1386169233
Name:STUART, BRIDGITTE V (MS, RBT, LMHC)
Entity type:Individual
Prefix:
First Name:BRIDGITTE
Middle Name:V
Last Name:STUART
Suffix:
Gender:F
Credentials:MS, RBT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N UNIVERSITY DR STE 500
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2009
Mailing Address - Country:US
Mailing Address - Phone:954-716-2427
Mailing Address - Fax:
Practice Address - Street 1:261 N UNIVERSITY DR STE 500
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2009
Practice Address - Country:US
Practice Address - Phone:954-716-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH18249101YM0800X
FLRBT-18-50916106S00000X
FLMH19071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician