Provider Demographics
NPI:1053079889
Name:IRIOOGBE, BRIDGET (LCPC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:IRIOOGBE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 MEDITERRANEAN DR
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3299
Mailing Address - Country:US
Mailing Address - Phone:815-787-9000
Mailing Address - Fax:815-787-9015
Practice Address - Street 1:1815 MEDITERRANEAN DR
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3299
Practice Address - Country:US
Practice Address - Phone:815-787-9000
Practice Address - Fax:815-787-9015
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016362101YP2500X
IL178.017557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional