Provider Demographics
NPI:1538248422
Name:BRIDGES, ELIZABETH G (LPC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:G
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:734 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9676
Mailing Address - Country:US
Mailing Address - Phone:336-869-1751
Mailing Address - Fax:336-869-8800
Practice Address - Street 1:1320 HAMILTON PLACE
Practice Address - Street 2:SUITE 103
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2608
Practice Address - Country:US
Practice Address - Phone:336-883-2900
Practice Address - Fax:336-883-2900
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103144Medicaid
NC1410XOtherBCBS PIN