Provider Demographics
NPI:1871056663
Name:CALLAGHAN, BRIDGETTE (LCSW)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:CALLAGHAN
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 1:8310 35TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5313
Mailing Address - Country:US
Mailing Address - Phone:201-452-4983
Mailing Address - Fax:
Practice Address - Street 1:8310 35TH AVE APT 2D
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5313
Practice Address - Country:US
Practice Address - Phone:201-452-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056892001041C0700X
NY0860961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical