Provider Demographics
NPI:1164029559
Name:SPICER, BRIDGET ANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:ANNE
Last Name:SPICER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8945 POWDERDAM DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5453
Mailing Address - Country:US
Mailing Address - Phone:404-915-1964
Mailing Address - Fax:
Practice Address - Street 1:8945 POWDERDAM DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-5453
Practice Address - Country:US
Practice Address - Phone:404-915-1964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional