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Bridge City Counseling Llc

Bridge City Counseling Llc is a health care provider in Portland, OR. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 712 Se Hawthorne Blvd, Suite 100, Portland, OR 97214-3538, US
Practice Location Phone503-545-5329
Practice Location Fax503-327-8005
Legal Business NameBRIDGE CITY COUNSELING LLC
NPI ?1407284953
Entity TypeOrganization
Enumeration Date ? Oct 19, 2013
Last Update Date ? Apr 13, 2016
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Bridge City Counseling Llc

SpecialtySpecializationLicenseLicense State
CounselorProfessional C2381Oregon

legacy-id-icon Legacy Provider IDs of Bridge City Counseling Llc

Provider IdIssuer StateIssuer TypeIssuer
500669729OregonMedicaid

official-icon Authorized Official of Bridge City Counseling Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Bridge City Counseling Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Nathanael Bagley (LPC)
Authorized Official Title/PositionOWNER
Authorized Official Phone Number503-545-5329