Provider Demographics
NPI:1427532282
Name:INNER BRIDGES COUNSELING
Entity type:Organization
Organization Name:INNER BRIDGES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:H
Authorized Official - Middle Name:ELAINA
Authorized Official - Last Name:DENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:802-579-1288
Mailing Address - Street 1:81 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6652
Mailing Address - Country:US
Mailing Address - Phone:802-579-1288
Mailing Address - Fax:802-246-1261
Practice Address - Street 1:81 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6652
Practice Address - Country:US
Practice Address - Phone:802-579-1288
Practice Address - Fax:802-246-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0062095101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1020486Medicaid
12341487OtherCAQH
4525867OtherCIGNA