BRIDGE TO ADULTHOOD LLC NPI 1356839187

NPI Information

NPI: 1356839187
Provider Name: BRIDGE TO ADULTHOOD, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
5345 RUSSELLVILLE RD
ALLENSVILLE, KY
ZIP 42204
Phone: (270) 987-4456
Get Directions

BRIDGE TO ADULTHOOD, LLC is a mental health counselor in Allensville, KY. BRIDGE TO ADULTHOOD, LLC NPI is 1356839187. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5345 RUSSELLVILLE RD
ALLENSVILLE, KY
ZIP 42204-024
Phone: (270) 987-4456
Fax: (888) 270-7319

The provider's authorized official is Brian Comley .
The authorized official title is Program Director and has the following contact phone number (270) 987-4456.

The enumeration date for this NPI number is 4/26/2018 and was last updated on 4/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1041C0700X	Social Worker	Clinical	253242	KENTUCKY	No
2	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100496400	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »