Provider Demographics
NPI:1699330076
Name:BOULDING-BRIDGES, JAMES (LPC, CST)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BOULDING-BRIDGES
Suffix:
Gender:M
Credentials:LPC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18344 WALLINGFORD AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4631
Mailing Address - Country:US
Mailing Address - Phone:786-988-0595
Mailing Address - Fax:
Practice Address - Street 1:11416 SLATER AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4600
Practice Address - Country:US
Practice Address - Phone:206-741-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3741101YM0800X
WALH61168984101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty