Provider Demographics
NPI:1598499717
Name:BRIDGETTE MILLER CHILD COUNSLEING
Entity Type:Organization
Organization Name:BRIDGETTE MILLER CHILD COUNSLEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY AND CHILD THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:608-577-3131
Mailing Address - Street 1:579 DONOFRIO DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2838
Mailing Address - Country:US
Mailing Address - Phone:608-577-3131
Mailing Address - Fax:608-299-3906
Practice Address - Street 1:579 DONOFRIO DR STE 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2838
Practice Address - Country:US
Practice Address - Phone:608-577-3131
Practice Address - Fax:608-299-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty