Provider Demographics
NPI:1922305507
Name:BRIDGER, JOANNA LUNT HOOPER (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:LUNT HOOPER
Last Name:BRIDGER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 CHAUNCEY ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1974
Mailing Address - Country:US
Mailing Address - Phone:617-895-9927
Mailing Address - Fax:
Practice Address - Street 1:222 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1262
Practice Address - Country:US
Practice Address - Phone:781-878-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical