Provider Demographics
NPI:1679351456
Name:BRIGHT WATER COUNSELING
Entity Type:Organization
Organization Name:BRIGHT WATER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLPC
Authorized Official - Phone:231-715-1166
Mailing Address - Street 1:1212 VETERANS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4734
Mailing Address - Country:US
Mailing Address - Phone:231-715-1166
Mailing Address - Fax:
Practice Address - Street 1:1212 VETERANS DR STE 202
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4734
Practice Address - Country:US
Practice Address - Phone:231-715-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health