Provider Demographics
NPI:1912137480
Name:LAROCHE, BRIDGET (LCSW, LADC)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:MISS
Other - First Name:BRIDGET
Other - Middle Name:
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LADC
Mailing Address - Street 1:682 BOOTHBY RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:ME
Mailing Address - Zip Code:04253-4020
Mailing Address - Country:US
Mailing Address - Phone:207-653-9191
Mailing Address - Fax:
Practice Address - Street 1:32 MAIN ST # 5
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1244
Practice Address - Country:US
Practice Address - Phone:207-200-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4927101YA0400X
MELC185151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)