Shayla Bridgewater, LMHCA
Individual provider Active NPI Mental Health Counselor · Etna Green, IN
NPI 1386570547 · NPPES record last updated Jun 23, 2026
Key facts
- NPI
- 1386570547
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 88003360A (IN)
- Practice address
- 8972 W 125 N
Etna Green, IN 46524-9521 - Phone
- (574) 201-7495
- NPI assigned
- Jun 23, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 88003360A | IN | Yes |
Addresses
Primary practice location
8972 W 125 N
Etna Green, IN 46524-9521
Mailing address
8972 W 125 N
Etna Green, IN 46524-9521
Phone (574) 201-7495
Other providers in Etna Green, IN
All providers in Etna Green, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 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.