Provider Demographics
NPI:1477042562
Name:BRIGHT PATH THERAPY & ASSOCIATES, LLC.
Entity Type:Organization
Organization Name:BRIGHT PATH THERAPY & ASSOCIATES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOGAL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:917-554-3669
Mailing Address - Street 1:987 OLD EAGLE SCHOOL RD STE 719
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1708
Mailing Address - Country:US
Mailing Address - Phone:610-971-2277
Mailing Address - Fax:610-971-0144
Practice Address - Street 1:987 OLD EAGLE SCHOOL RD STE 719
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1708
Practice Address - Country:US
Practice Address - Phone:610-971-2277
Practice Address - Fax:610-971-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA017028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty