Provider Demographics
NPI:1376938779
Name:NEW BRIDGE COUNSELING SERVICES
Entity Type:Organization
Organization Name:NEW BRIDGE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAWS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, CSAT
Authorized Official - Phone:916-729-3242
Mailing Address - Street 1:2377 GOLD MEADOW WAY, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670
Mailing Address - Country:US
Mailing Address - Phone:916-729-3242
Mailing Address - Fax:916-631-1573
Practice Address - Street 1:2377 GOLD MEADOW WAY, SUITE 100
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670
Practice Address - Country:US
Practice Address - Phone:916-729-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36717106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty