1356777452 NPI number — ESTHER ROCHELLE BRIDGES MA, LMFT, CDWF

Table of content: ESTHER ROCHELLE BRIDGES MA, LMFT, CDWF (NPI 1356777452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356777452 NPI number — ESTHER ROCHELLE BRIDGES MA, LMFT, CDWF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRIDGES
Provider First Name:
ESTHER
Provider Middle Name:
ROCHELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT, CDWF
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356777452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1414 S FRIENDSWOOD DR
Provider Second Line Business Mailing Address:
SUITE 118A
Provider Business Mailing Address City Name:
FRIENDSWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77546-4831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-819-0144
Provider Business Mailing Address Fax Number:
281-946-5109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 S FRIENDSWOOD DR
Provider Second Line Business Practice Location Address:
SUITE 118A
Provider Business Practice Location Address City Name:
FRIENDSWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77546-4831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-819-0144
Provider Business Practice Location Address Fax Number:
281-946-5109
Provider Enumeration Date:
09/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  201944 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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