BRIDGEWAY COUNSELING CENTER, LC (NPI# 1750396636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750396636 |
| Entity Type | Organization |
| Organization Name | BRIDGEWAY COUNSELING CENTER, LC |
| Practice Address |
1630 23rd Ave Suite 301b Lewiston ID 83501-6350 |
| Mailing Address |
317 15th Ave Lewiston ID 83501-2757 |
| Practice Telephone | 2087466776 |
| Practice Fax Number | 2087461938 |
| Mailing Telephone | 2087466776 |
| Mailing Fax Number | 2087461938 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | FRANK E SHULL (OWNER) |
| Authorized Official Telephone | 2087466776 |
| Authorized Official Credential | M.ED. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| X | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1630 23RD AVE SUITE 301B |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-6350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717787 | Richard Michael Allen | Podiatrist | 1630 23rd Ave, Suite 1001, Lewiston, ID 83501-6350 | 2005-08-11 |
| 1700221363 | Marion Elizabeth Smith | Nurse Practitioner | 1630 23rd Ave, Lewiston, ID 83501-6350 | 2013-05-08 |
| 1154662948 | Cory Allen Brown | Podiatrist | 1630 23rd Ave, Suite 1001, Lewiston, ID 83501-6350 | 2013-03-05 |
| 1124250527 | Cynthia Hudson | Dietitian, Registered | 1630 23rd Ave, Suite 401, Lewiston, ID 83501-6350 | 2009-08-18 |
| 1700073798 | Amber Christine Mckinney | Physician Assistant | 1630 23rd Ave, Suite 701, Lewiston, ID 83501-6350 | 2007-10-03 |
| 1881881118 | Steven E Ozeran, M.d., P.a. | Surgery | 1630 23rd Ave, Suite 901a, Lewiston, ID 83501-6350 | 2007-10-01 |
| 1194926790 | Snake River Rehabilitation Counseling Services,llc | Day Training, Developmentally Disabled Services | 1630 23rd Ave, # 301b, Lewiston, ID 83501-6350 | 2007-05-30 |
| 1588610398 | Walla Walla Vamc | Clinic/Center | 1630 23rd Ave, Stes. 302 & 401, Bldg. 2, Lewiston, ID 83501-6350 | 2006-05-25 |
| 1316911571 | Steven Edwin Ozeran | Surgery | 1630 23rd Ave, Ste 901a, Lewiston, ID 83501 | 2006-02-15 |
| 1578552139 | Michael K Parent | Specialist | 1630 23rd Ave, Suite 701, Lewiston, ID 83501-6350 | 2005-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550108 | Jasmine Dawn Hussey | Social Worker | 17 Cram Ave Apt 3, Lewiston, ME 04240-3750 | 2020-05-26 |
| 1124650106 | Summer Overberg | Social Worker | 908 Idaho St, Lewiston, ID 83501-1937 | 2020-02-07 |
| 1922665173 | Shana Wallace | Social Worker | 150 South Ave # 2, Lewiston, ME 04240-5759 | 2019-05-23 |
| 1407336746 | Kelsey Wilcox | Social Worker | 37 Park St Ste 203, Lewiston, ME 04240-7195 | 2018-08-16 |
| 1003301680 | Serenity Treatment LLC | Social Worker | 1229 Main St Ste 101, Lewiston, ID 83501-6901 | 2018-06-26 |
| 1053830299 | Rebecca Baker | Social Worker | 37 Park St Ste 201, Lewiston, ME 04240-7196 | 2017-09-19 |
| 1043660343 | Heath B Walters | Social Worker | 504 Main St Ste 470, Lewiston, ID 83501-1806 | 2016-06-16 |
| 1700253614 | Eric Stephen Esty | Social Worker | 35 Westminster St, Lewiston, ME 04240-3531 | 2015-08-26 |
| 1205213857 | Brandon Mcintosh | Social Worker | 523 1/2 Main St Ste 7, Lewiston, ID 83501-1870 | 2015-05-04 |
| 1285026229 | Lauren Nichols | Social Worker | 1310 9th Ave, Lewiston, ID 83501-3104 | 2015-02-27 |
| Find all providers in LEWISTON | ||||
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| 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.