| Bridges Counseling Services | |
|
3280 E Beltline Ct Ne Grand Rapids MI 49525-9494 | |
| (616) 447-3404 | |
| Not Available |
| Full Name | Bridges Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 3280 E Beltline Ct Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Gayle M Witham (LMSW) |
| Authorized Official Contact | 6164773404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridges Counseling Services 3280 E Beltline Ct Ne Grand Rapids MI 49525-9494 Ph: () - | Bridges Counseling Services 3280 E Beltline Ct Ne Grand Rapids MI 49525-9494 Ph: (616) 447-3404 |
| NPI Number | 1003454364 |
|---|---|
| Provider Enumeration Date | 12/18/2019 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Medicare PECOS PAC ID | 1557792744 |
|---|---|
| Medicare Enrollment ID | O20200501001946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003454364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gayle Witham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104330307 PECOS PAC ID: 4284065475 Enrollment ID: I20200501002023 |
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