| Hidden Bridges, Llc | |
|
1949 Sugarland Dr Ste 122 Sheridan WY 82801-5763 | |
| (307) 429-0644 | |
| (307) 675-4920 |
| Full Name | Hidden Bridges, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1949 Sugarland Dr Ste 122, Sheridan, Wyoming |
| Authorized Official Name and Position | Julie Nicks-irvine (SOLE MEMBER) |
| Authorized Official Contact | 3074290644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Bridges, Llc 1454 N Heights Ln Sheridan WY 82801-2123 Ph: (307) 751-0032 | Hidden Bridges, Llc 1949 Sugarland Dr Ste 122 Sheridan WY 82801-5763 Ph: (307) 429-0644 |
| NPI Number | 1578248118 |
|---|---|
| Provider Enumeration Date | 06/20/2023 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 0042661431 |
|---|---|
| Medicare Enrollment ID | O20240110002269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578248118 | NPI | - | NPPES |
| Provider Name | Julie Nicks-irvine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447847553 PECOS PAC ID: 2860843257 Enrollment ID: I20240110002309 |
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