Mack, Bridgette Denise
Mack, Bridgette Denise is an sole proprietor health care provider with primary practice located at 312 Sw Greenwich Dr Ste 733 , Lees Summit MO 64082-4408. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mack, Bridgette Denise can be contacted via phone (913) 712-0565.Contact Information
Primary practice address
312 Sw Greenwich Dr Ste 733
Lees Summit MO 64082-4408
Phone: (913) 712-0565
Fax: (816) 537-8605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2001031951 | Missouri |
Profile Details
| NPI number | 1144423625 |
|---|---|
| LBN Legal business name | Mack, Bridgette Denise |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2007 |
| Last updated | Jan 22nd, 2022 - about 3 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 | 1144423625 | NPPES |
| Missouri | MEDICAID | 499012508 |
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