Provider Demographics
NPI:1851845994
Name:BRIGHTER HORIZONS PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:BRIGHTER HORIZONS PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-671-2381
Mailing Address - Street 1:PO BOX 550224
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28055-0224
Mailing Address - Country:US
Mailing Address - Phone:704-671-2381
Mailing Address - Fax:
Practice Address - Street 1:839 MAJESTIC CT STE 9
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5152
Practice Address - Country:US
Practice Address - Phone:704-671-2381
Practice Address - Fax:704-919-5423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NC5326251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management