Bridgeside Counseling Services, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BRIDGESIDE COUNSELING SERVICES, PLLC

Practice address

3173 Wrightsville Ave
Wilmington, NC 28403-4184

Phone

(910) 769-5353

Fax

(910) 660-0526

NPI assigned

Jul 26, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia Dale Estadt, LCMHCNPI 1336600394

Title

Owner

Phone

(931) 769-5353

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia D Estadt, LCMHC

  • Mental Health Counselor
  • Asheville, NC
  • NPI 1336600394
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1285307348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034184",
            "telephone_number": "910-769-5353",
            "fax_number": "910-660-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034184",
            "telephone_number": "910-769-5353",
            "fax_number": "910-660-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGESIDE COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "ESTADT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-769-5353",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pattysplaytherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3173 Wrightsville Ave",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284034184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.