Provider Demographics
NPI:1790080273
Name:BRIGHT SPIRIT COUNSELING, INC.
Entity Type:Organization
Organization Name:BRIGHT SPIRIT COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCNULTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PCC, LSW, LICDC
Authorized Official - Phone:440-781-4546
Mailing Address - Street 1:1450 SOM CENTER RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2118
Mailing Address - Country:US
Mailing Address - Phone:440-781-4546
Mailing Address - Fax:440-461-1672
Practice Address - Street 1:1450 SOM CENTER RD
Practice Address - Street 2:SUITE 20
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2118
Practice Address - Country:US
Practice Address - Phone:440-781-4546
Practice Address - Fax:440-461-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0003566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty