1760570204 NPI number — BRIGHT COUNSELING, INCORPORATED

Table of content: (NPI 1760570204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760570204 NPI number — BRIGHT COUNSELING, INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT COUNSELING, INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1760570204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4515 ASHLEY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21043-6045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-750-9033
Provider Business Mailing Address Fax Number:
410-461-4809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7120 MINSTREL WAY
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-227-6583
Provider Business Practice Location Address Fax Number:
410-461-4809
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GARROWAY
Authorized Official First Name:
THERESE
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-227-6583

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  LC1099 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YM0800X , with the licence number: LC1099 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YP2500X , with the licence number: LC1099 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LC1099 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: J1850005 . This is a "CAREFIRST DC PROVIDER #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64276301 . This is a "CAREFIRST MD PROVIDER #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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