Provider Demographics
NPI:1851533673
Name:RICHARD, BRIDGET SIMONE (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:SIMONE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360823
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-0014
Mailing Address - Country:US
Mailing Address - Phone:330-331-5800
Mailing Address - Fax:330-331-5805
Practice Address - Street 1:323 S COURT ST STE 210
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3715
Practice Address - Country:US
Practice Address - Phone:330-331-5800
Practice Address - Fax:330-331-5805
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical