Provider Demographics
NPI:1689963449
Name:BRIDGES COUNSELING
Entity Type:Organization
Organization Name:BRIDGES COUNSELING
Other - Org Name:HEATHER DIDOMENICO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DIDOMENICO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:973-634-5171
Mailing Address - Street 1:109 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1453
Mailing Address - Country:US
Mailing Address - Phone:973-668-4806
Mailing Address - Fax:
Practice Address - Street 1:109 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1453
Practice Address - Country:US
Practice Address - Phone:973-634-5171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00317200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty