Provider Demographics
NPI:1649556770
Name:BRIGHTSIDE COUNSELING LLC
Entity Type:Organization
Organization Name:BRIGHTSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-264-2272
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:LEDERACH
Mailing Address - State:PA
Mailing Address - Zip Code:19450-0255
Mailing Address - Country:US
Mailing Address - Phone:215-264-2272
Mailing Address - Fax:215-256-1112
Practice Address - Street 1:701 CROSS ROAD
Practice Address - Street 2:
Practice Address - City:LEDERACH
Practice Address - State:PA
Practice Address - Zip Code:19450
Practice Address - Country:US
Practice Address - Phone:215-264-2272
Practice Address - Fax:215-256-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty