Provider Demographics
NPI:1508154196
Name:BRIDGES, LADAWN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LADAWN
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CELTIC DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2894
Mailing Address - Country:US
Mailing Address - Phone:919-792-8355
Mailing Address - Fax:
Practice Address - Street 1:58 CELTIC DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2894
Practice Address - Country:US
Practice Address - Phone:919-797-8419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0090911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical