Provider Demographics
NPI:1033860333
Name:BRIGHTER PATHWAYS PSYCHIATRY
Entity type:Organization
Organization Name:BRIGHTER PATHWAYS PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MODELFINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-855-9520
Mailing Address - Street 1:6301 BANSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6572
Mailing Address - Country:US
Mailing Address - Phone:804-855-9520
Mailing Address - Fax:
Practice Address - Street 1:6301 BANSHIRE DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-6572
Practice Address - Country:US
Practice Address - Phone:804-855-9520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty