Provider Demographics
NPI:1881251908
Name:NASH, BRIDGET (LPC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:NASH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9361 CHERRY VALLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9506
Mailing Address - Country:US
Mailing Address - Phone:616-202-1280
Mailing Address - Fax:
Practice Address - Street 1:9361 CHERRY VALLEY AVE SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9506
Practice Address - Country:US
Practice Address - Phone:616-202-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019391101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401017328OtherCASH, BCBS, ASR