| Bridge Psychotherapy Llc | |
|
47 Main St Old Mystic CT 06372-7700 | |
| (860) 214-7439 | |
| Not Available |
| Full Name | Bridge Psychotherapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 47 Main St, Old Mystic, Connecticut |
| Authorized Official Name and Position | Bridget Doyle- Kusy (OWNER/SOLE PROPRIETOR) |
| Authorized Official Contact | 8602147439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Psychotherapy Llc Po Box 0562 Bridge Psychotherapy Old Mystic CT 06372 Ph: () - | Bridge Psychotherapy Llc 47 Main St Old Mystic CT 06372-7700 Ph: (860) 214-7439 |
| NPI Number | 1518475383 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 01/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518475383 | NPI | - | NPPES |
| 006035 | Other | CT | LCSW- LICENSE |
| 1306088984 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 006035 (Connecticut) | Primary |