Provider Demographics
NPI:1447553151
Name:BRIGHT HORIZONS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:BRIGHT HORIZONS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-725-4204
Mailing Address - Street 1:112 HUNTING CREEK LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4638
Mailing Address - Country:US
Mailing Address - Phone:703-725-4204
Mailing Address - Fax:
Practice Address - Street 1:2126 JEFFERSON DAVIS HWY
Practice Address - Street 2:103
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7294
Practice Address - Country:US
Practice Address - Phone:703-725-4204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-19
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty