Provider Demographics
NPI:1811003304
Name:BRIDGES, EILEEN V (LCSW ACSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:V
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LCSW ACSW
Other - Prefix:MRS
Other - First Name:EILEEN
Other - Middle Name:V
Other - Last Name:BIBLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 N 17TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5014
Mailing Address - Country:US
Mailing Address - Phone:610-820-3900
Mailing Address - Fax:610-820-3835
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5014
Practice Address - Country:US
Practice Address - Phone:610-820-3900
Practice Address - Fax:610-820-3835
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW007367L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA94231OtherHIGHMARK BLUE SHIELD
P3173694OtherOXFORD
PA01531502OtherCAPITAL BLUE CROSS
PAP00053032OtherRAILROAD MEDICARE
PAP00053032OtherRAILROAD MEDICARE