Peggy Lynn Bridges, BS, CRADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kennett, MO
NPI 1639371842 · NPPES record last updated Mar 5, 2013
Key facts
- NPI
- 1639371842
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 2938 (MO)
- Practice address
- 1109 Jones St
Kennett, MO 63857-3824 - Phone
- (573) 888-6545
- Fax
- (573) 888-2369
- NPI assigned
- Jun 1, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2938 | MO | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2938 | MO | Yes |
Addresses
Primary practice location
1109 Jones St
Kennett, MO 63857-3824
Mailing address
1109 Jones St
PO Box 470
Kennett, MO 63857-3824
Phone (573) 888-6545
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 507496 | Other | MO | HEALTHLINK PPO |
| 162252 | Other | MO | BLUE CHOICE |
| 162252 | Other | MO | BLUE CROSS AND BLUE SHIEL |
Other providers in Kennett, MO
- Marsha J Branum
- Teresa Brasher
- Dione A Breakfield
- Joleen Brege
- Ashlyn Paige Bridges
- Tonya Renee Bridges
- Jessica Elaine Britt
- Emmelee Jean Britton-Harper
- Judy Britton
- Charles Broadway
All providers in Kennett, MO · Addiction (Substance Use Disorder) Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2013. 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.