Provider Demographics
NPI:1609121003
Name:MCLAUGHLIN, BRIDGET (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 N CAMBRIDGE AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7552
Mailing Address - Country:US
Mailing Address - Phone:708-927-9782
Mailing Address - Fax:
Practice Address - Street 1:2821 N CAMBRIDGE AVE APT 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7552
Practice Address - Country:US
Practice Address - Phone:708-927-9782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-21
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171R00000X, 390200000X
IL390200000X
IL149.0218181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171R00000XOther Service ProvidersInterpreter
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program