Provider Demographics
NPI:1720845902
Name:BRIDGETT BEAL, LCSW, LLC
Entity Type:Organization
Organization Name:BRIDGETT BEAL, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNTER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-552-0945
Mailing Address - Street 1:PO BOX 9322
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-9322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10305 VALLEY GROVE DR
Practice Address - Street 2:
Practice Address - City:LOLO
Practice Address - State:MT
Practice Address - Zip Code:59847-8604
Practice Address - Country:US
Practice Address - Phone:406-552-0945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty