Active NPI
Bridget Atchley, M.ED., NCC, LPC
- Professional Counselor
- Southport, NC
National Provider Identifier
1669467650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 756
- Practice address
- 5003 Oquinn Blvd SE Ste B
South Harbour Village
Southport, NC 28461-7431 - Phone
- (910) 457-5940
- Fax
- (910) 457-4379
- NPI assigned
- Sep 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 756 | NC | Primary |
Addresses
Primary practice location
5003 Oquinn Blvd SE Ste B
South Harbour Village
Southport, NC 28461-7431
Mailing address
702 W 9TH St
Southport, NC 28461-2917
Phone (910) 457-5940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6104423 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 12, 2024 through Apr 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 756 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301270400000",
"number": "1669467650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 W 9TH ST",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284612917",
"telephone_number": "910-457-5940",
"fax_number": "910-457-4379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5003 OQUINN BLVD SE STE B",
"address_2": "SOUTH HARBOUR VILLAGE",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284617431",
"telephone_number": "910-457-5940",
"fax_number": "910-457-4379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATCHLEY",
"first_name": "BRIDGET",
"credential": "M.ED., NCC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-15",
"last_updated": "2011-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6104423",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.