Jackson, Bridgette

Jackson, Bridgette is an individual health care provider with primary practice located at 440 N Main St # D , Bristol CT 06010-4990. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Jackson, Bridgette can be contacted via phone (860) 314-2052.

Contact Information

Primary practice address
440 N Main St # D Bristol CT 06010-4990
Phone: (860) 314-2052
Fax: (860) 314-2054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 001126 Connecticut

Profile Details

NPI number 1093721706
LBN Legal business name Jackson, Bridgette
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Aug 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093721706 NPPES
Connecticut MEDICAID 004262812

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