Provider Demographics
NPI:1073371035
Name:CAIN, BRIDGET LEIGH
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:LEIGH
Last Name:CAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SCHUYLER ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1652
Mailing Address - Country:US
Mailing Address - Phone:315-671-5426
Mailing Address - Fax:
Practice Address - Street 1:113 SCHUYLER ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1652
Practice Address - Country:US
Practice Address - Phone:315-671-5426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP127500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health