Provider Demographics
NPI:1396959268
Name:BAY BRIDGE COUNSELING, LLC
Entity type:Organization
Organization Name:BAY BRIDGE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-899-0701
Mailing Address - Street 1:1648 BAY AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4502
Mailing Address - Country:US
Mailing Address - Phone:732-899-0701
Mailing Address - Fax:723-899-6962
Practice Address - Street 1:1648 BAY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4502
Practice Address - Country:US
Practice Address - Phone:732-899-0701
Practice Address - Fax:723-899-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05270600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty