Provider Demographics
NPI:1184113847
Name:BRIDGEFORH, SHENNA (LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:SHENNA
Middle Name:
Last Name:BRIDGEFORH
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 DONELSON PIKE STE A7
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2975
Mailing Address - Country:US
Mailing Address - Phone:615-499-1275
Mailing Address - Fax:615-401-7174
Practice Address - Street 1:1410 DONELSON PIKE STE A7
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2975
Practice Address - Country:US
Practice Address - Phone:615-499-1275
Practice Address - Fax:615-401-7174
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional