Leicester, Bridget
Leicester, Bridget is an individual health care provider with primary practice located at 90 Mahoney Ave Psychiatry & Psychotherapy Assocs, Rutland VT 05701-0000. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Leicester, Bridget can be contacted via phone (802) 775-2581.Contact Information
Primary practice address
90 Mahoney Ave Psychiatry & Psychotherapy Assocs
Rutland VT 05701-0000
Phone: (802) 775-2581
Fax: (802) 775-3395
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 089-0000928 | Vermont |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R042998-1 | New York |
Profile Details
| NPI number | 1063448694 |
|---|---|
| LBN Legal business name | Leicester, Bridget |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063448694 | NPPES |
| New York | MEDICAID | 01562610 | |
| New York | Other | 59551 | |
| New York | MEDICAID | 1009403 | |
| New York | Other | 412173 |
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