Provider Demographics
NPI:1205605292
Name:RHOTEN, BRIDGET (LCSW)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:RHOTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 N 200 E
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:UT
Mailing Address - Zip Code:84333-1702
Mailing Address - Country:US
Mailing Address - Phone:435-760-4171
Mailing Address - Fax:
Practice Address - Street 1:3746 S 4800 W
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84339-9785
Practice Address - Country:US
Practice Address - Phone:435-245-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8974272-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical