Provider Demographics
NPI:1972974079
Name:BRIGHT BEGINNINGS PSYCHIATRY LLC
Entity Type:Organization
Organization Name:BRIGHT BEGINNINGS PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DE LAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-507-1914
Mailing Address - Street 1:10425 W NORTH AVE
Mailing Address - Street 2:SUITE 314
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2416
Mailing Address - Country:US
Mailing Address - Phone:414-671-9492
Mailing Address - Fax:
Practice Address - Street 1:10425 W NORTH AVE
Practice Address - Street 2:SUITE 314
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2416
Practice Address - Country:US
Practice Address - Phone:414-671-9492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57260-202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467606616OtherNPI NUMBER