Bridgewater Counseling Services, LLC
Organization Active NPI Clinical Social Worker · Breese, IL
NPI 1144847880 · NPPES record last updated Jul 9, 2026
Key facts
- NPI
- 1144847880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- BRIDGEWATER COUNSELING SERVICES, LLC
- Practice address
- 10551 Vonder Haar LN
Breese, IL 62230-4316 - Phone
- (618) 520-3339
- NPI assigned
- Jun 29, 2020
- Organization subpart
- No
Authorized official
- Name
- Renee M Keller, LCSW
- Title
- Psychotherapist
- Phone
- (618) 520-3339
Practitioners 1
-
Renee Keller, LCSW
National Provider Directory
Locations
4010 N Illinois St
Ste 1
Swansea, IL 62226
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
10551 Vonder Haar LN
Breese, IL 62230-4316
Mailing address
10551 Vonder Haar LN
Breese, IL 62230-4316
Phone (618) 520-3339
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487841714 | Other | NPI | |
| 2012036897 | Other | MO | PROFESSIONAL CLINICAL SOCIAL WORK LICENSE |
| 149015007 | Other | IL | PROFESSIONAL LICENSE |
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- Breese Dental Group PC.
- Breese SCH Dist 12
- Kristina G Buehne
- Jessica Lynn Campbell
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- Cep America Illinois Intensivists
All providers in Breese, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.