BRIDGEWATER COUNSELING SERVICES, LLC


Address: 4010 N Illinois St Ste 1, Swansea, IL 62226-1967
Phone: 6184070900

BRIDGEWATER COUNSELING SERVICES, LLC (NPI# 1144847880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144847880
Entity Type Organization
Organization Name BRIDGEWATER COUNSELING SERVICES, LLC
Practice Address 4010 N Illinois St Ste 1
Swansea
IL 62226-1967
Practice Telephone 6184070900
Mailing Telephone 6184070900
Enumeration Date 2020-06-29
Last Update Date 2020-06-29
Authorized Official Name RENEE MARIE KELLER (PRINCIPAL)
Authorized Official Telephone 6185203339
Authorized Official Credential LCSW
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NPI 1487841714 01
MO PROFESSIONAL CLINICAL SOCIAL WORK LICENSE 2012036897 01
IL PROFESSIONAL LICENSE 149015007 01

Office Location

Street Address 4010 N ILLINOIS ST STE 1
City SWANSEA
State IL
Zip Code 62226-1967

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639778160 Roxanna Lee Gunnels Nurse Practitioner 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 2020-10-26
1053969790 Consistent Medical Transportation Driver 2012 N 17th St, Swansea, IL 62226 2019-08-27
1497314371 Medi-plex Hospice of Illinois, LLC Registered Nurse 8 Park Place, Suite #3, Swansea, IL 62226 2019-06-13
1336617364 Nicole Renee Schmidt Speech-Language Pathologist 150 N 27th St., Belleville, IL 62226 2018-11-07
1295258903 Catherine Espino Pharmacist 11 Chambers Blvd, Swansea, IL 62226 2017-07-25
1366806838 Kiley Faires Nurse Practitioner 4600 Memorial Drive Ste 360, Belleville, IL 62226 2016-04-11
1760857585 Mvp Transportation Non-emergency Medical Transport (VAN) 1229 N 17th Street, Number 23, Belleville, IL 62226 2015-12-04
1275952566 Aisha Danyale Franklin Internal Medicine 4261 Woodfield Pl, Belleville, IL 62226 2014-04-15
1396168332 Jayne E. Ninness Physical Therapy Assistant 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 2014-01-28
1053758193 Gateway Foundation, Inc. Clinic/Center 1 Bronze Point, Suite 1, Swansea, IL 62226 2013-05-30
Find all providers in zip 62226

Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366071854 Jocelyn R. Cross Social Worker 7 Bronze Pointe S Ste B2, Swansea, IL 62226-8308 2020-04-06
1043784382 Patrick A Frame Social Worker 208 W Pointe Dr # B, Swansea, IL 62226-8302 2019-01-21
1003399205 Patricia Ann Golden Social Worker 377 Bark St, Swansea, MA 02777 2018-09-13
1275933921 Traci Rigano Social Worker 664 Stevens Road, Swansea, MA 02777 2014-08-31
1265682942 Tiffany Rose Hislope Social Worker 5 Executive Woods Ct Lowr Level, Swansea, IL 62226-2171 2008-09-30
1053582007 Henry F Fairman Social Worker 73 Touisset Ave, Swansea, MA 02777-1122 2008-03-18
1740467919 Kathleen M Mcmullan Social Worker 208 West Pointe Drive, Suite B, Swansea, IL 62226-8302 2008-01-29
1831230846 Debra Jo Bellm Social Worker 6 Emerald Ter Ste 4, Swansea, IL 62226-2312 2007-02-11
1851442735 Michael Friend Social Worker 25 Market St Ste 14, Swansea, MA 02777-3998 2007-01-16
1518054378 Renee Schilling Krebel Social Worker 5 Executive Woods Ct, Swansea, IL 62226-2170 2006-10-05
Find all providers in SWANSEA

Competitor

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City SWANSEA
Zip Code 62226

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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