NPIMap

Organization Active NPI

Bridgewater Counseling PLLC

  • Counselor
  • Idaho Falls, ID
National Provider Identifier
1982056115
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
BRIDGEWATER COUNSELING PLLC
Practice address
1075 S Utah Ave
Idaho Falls, ID 83402-3327
Phone
(208) 970-9907
NPI assigned
Jul 12, 2016
Last updated
Jul 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Sheila DabellNPI 1811174063
Title
Owner
Phone
(208) 970-9907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

1075 S Utah Ave
Idaho Falls, ID 83402-3327

Mailing address

1075 S Utah Ave
Idaho Falls, ID 83402-3327

National Provider Directory

National Provider Directory

Locations

1075 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 970-9907

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1982056115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023327",
            "telephone_number": "208-970-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "DABELL",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-970-9907"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.