Provider Demographics
NPI:1326493586
Name:BRIGHT FUTURES COUNSELING LLC
Entity Type:Organization
Organization Name:BRIGHT FUTURES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LSW
Authorized Official - Phone:732-710-6319
Mailing Address - Street 1:11 DEVOE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08882-1939
Mailing Address - Country:US
Mailing Address - Phone:732-710-6319
Mailing Address - Fax:
Practice Address - Street 1:11 DEVOE ST
Practice Address - Street 2:
Practice Address - City:SOUTH RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08882-1939
Practice Address - Country:US
Practice Address - Phone:732-710-6319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health